Abstract
Although liver biopsy is currently regarded as the gold standard for staging liver fibrosis in chronic hepatitis C, it is a costly invasive procedure and carries a small risk for complication. Our aim in this study was to construct a simple model to distinguish between patients with no or mild fibrosis (METAVIR F0–F1) versus those with clinically significant fibrosis (METAVIR F2–F4). We retrospectively studied 204 consecutive CHC patients. Thirty-four serum markers with age, gender, duration of infection were assessed to classify fibrosis with a classifier known as the support vector machine (SVM). The method of feature selection known as sequential forward floating selection (SFFS) was introduced before the performance of SVM. When four serum markers were extracted with SFFS-SVM, F2–F4 could be predicted accurately in 96%. Our study showed that application of this model could identify CHC patients with clinically significant fibrosis with a high degree of accuracy and may decrease the need for liver biopsy.




Similar content being viewed by others
Abbreviations
- HCV:
-
hepatitis C virus
- CHC:
-
chronic hepatitis C
- SVM:
-
support vector machine
- SFFS:
-
sequential forward floating selection
References
National Institute of Health Consensus Development Conference Panel Statement, Management of hepatitis C. Hepatology 26:2S–10S, 1997.
Perrilo, R. P., The role of liver biopsy in hepatitis C. Hepatology 26:57S–61S, 1997.
Dienstag, J., The role of liver biopsy in chronic hepatitis C. Hepatology 36:S152–S160, 2002.
Cadranel, J. F., Rufat, P., and Degos, F., Practices of liver biopsy in France: Results of a prospective nationwide survey. Hepatology 32:477–481, 2000.
Poynard, T., Ratziu, V., and Bedossa, P., Appropriateness of liver biopsy. Can. J. Gastroenterol. 14:543–548, 2000.
Bedossa, P., Dargere, D., and Paradis, V., Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology 38:1449–1457, 2003.
Bedossa, P., Poynard, T., and the Metavir Cooperative Group, Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. Hepatology 20:15–20, 1994.
Westin, J., Lagging, L. M., Wejstal, R., Norkans, G., and Dhillon, A. P., Interobserver study of liver histology using the Ishak score in patients with chronic hepatitis C virus infection. Liver 19:183–187, 1999.
Regev, A., Berho, M., Jeffers, L. J., Milikowaki, C., Molina, E. G., Pyrsopoulos, N. T., Feng, Z. Z., et al., Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am. J. Gastroenterol. 97:2614–2618, 2002.
Poynard, T., and Bedossa, P., Age and platelet count: A simple index for predicting the presence of histological lesions in patients with antibodies to hepatitis C virus. METAVIR and CLINVIR Cooperative Study Groups. J. Viral. Hepatol. 4:199–208, 1997.
Pohl, A., Behing, C., Oliver, D., Kilani, M., Monson, P., and Hassanein, T., Serum aminotransferase levels and platelet counts as predictors of degree of fibrosis in chronic hepatitis C virus infection. Am. J. Gastroenterol. 96:3142–3146, 2001.
Bonacini, M., Hadi, G., Govindarajan, S., and Linsday, K. L., Utility of a discriminant score for diagnosing advanced fibrosis or cirrhosis in patients with chronic hepatitis C virus infection. Am. J. Gastroenterol. 92:1302–1304, 1997.
Patel, K., McHutchison, J. G., Oh, E., Nguyen, P., and Rose, S., Evaluation and optimization of a panel of serum markers for liver fibrosis in chronic hepatitis C patients. Gastroenterology 122(suppl 1):M1610, 2002.
Imbert-Bismut, F., Ratziu, V., Pieroni, L., Charlotte, F., Benhamou, Y., and Poynard, T., Biochemical markers of liver fibrosis in patients with hepatitis C virus infection: A prospective study. Lancet 357:1069–1075, 2001.
Rossi, E., Adams, L., Prins, A., Bulsara, M., de Boer, B., Garas, G., et al., Validation of the FibroTest biochemical markers score in assessing liver fibrosis in hepatitis C patients. Clin. Chem. 49:450–454, 2003.
Halfon, P., Bourliere, M., Deydier, R., Portal, I., Renou, C., Bertrand, J. J., et al., Independent prospective multicenter validation of biochemical markers (Fibrotest-Actitest) for the prediction of liver fibrosis and activity in patients with chronic hepatitis C. 54th Annual Meeting of the AASLD, Hepatology 38:188A, 2003.
Forns, X., Ampurdanes, S., Llovet, J., Aponte, J., Quinto, L., and Martinez-Bauer, E., Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive model. Hepatology 36:986–992, 2003.
Wai, C. T., Greenson, J. K., Fontana, R. J., Kalbfleisch, J. D., Marrero, J. A., Conjeevaram, H. S., and Lok, A. S., A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology 38:518–526, 2003.
Bedossa, P., and Poynard, T., For the French METAVIR Cooperative Study Group. An algorithm for grading activity in chronic hepatitis C. Hepatology 24:289–293, 1996.
Cortes, C., and Vapnik, V., Machine Learn. 20:273–297, 1995.
Vapnik, V., The Nature of Statistical Learning Theory, Springer, Berlin, 1995.
Vapnik, V., Statistical Learning Theory, Wiley, New York, 1998.
Cai, Y. D., Liu, X. J., Xu, X., and Chou, K. C., Prediction of protein structural classes by support vector machines. Comput. Chem. 26:293–296, 2002.
Burbidge, R., Trotter, M., Buxton, B., and Holden, S., Drug design by machine learning: Support vector machines for pharmaceutiacal data alalysis. Comput. Chem. 26:5–14, 2001.
Warmuth, M. K., Liao, J., Ratsch, G., Mathieson, M., Putta, S., and Lemmen, C., Active learning with support vector machines in the drug discovery process. J. Chem. Inf. Comput. Sci. 43:667–673, 2003.
Bao, L., and Sun, Z. R., Identifying genes related to drug anticancer mechanisms using support vector machine. FEBS Lett. 521:109–114, 2002.
Guler, N. F., and Kocer, S., Use of support vector machines and neural network in diagnosis of neuromuscular disorders. J. Med. Syst. 29(3):271–284, 2005.
Pudil, P., Novovicova, J., and Kittler, J., Floating search methods in feature selection. Pattern Recognit. Lett. 15(11):1119–1125, 1994.
Schalkoff, R., Pattern Recognition, Wiley, New York, 1994.
Haydon, G. H., Jalan, R., Ala-Korpela, M., Hiltunen, Y., Hanley, J., Jarvis, L. M., Ludlum, C. A., and Hayes, P. C., Prediction of cirrhosis in patients with chronic hepatitis C infection by artificial neural network analysis of virus and clinical factors. J. Viral. Hepatol. 5:255–264, 1998.
Poon, T. C., Hui, A. Y., Chan, H. L., Ang, I. L., Chow, S. M., Wong, N., and Sung, J. J., Prediction of liver fibrosis and cirrhosis in chronic hepatitis B infection by serum proteomic fingerprinting: A pilot study. Clin. Chem. 51(2):328–335, 2005.
Yeh, W., Huang, S. W., and Li, P. C., Liver fibrosis grade classification with B-mode ultrasound. Ultrasound Med. Biol. 29(9):1229–1235, 2003.
Wong, V. S., Hughes, V., Trull, A., Wight, D. G., Petrik, J., and Alexander, G. J., Serum hyaluronic acid is a useful marker of liver fibrosis in chronic hepatitis C virus infection. J. Viral. Hepatol. 5:187–192, 1998.
Ikeda, K., Saitoh, S., Kobayashi, M., Suzuki, F., Arase, Y., et al., Distinction between chronic hepatitis C virus infection: Practical discriminant function using common laboratory data. Hepatol. Res. 18:252–266, 2000.
Acknowledgements
This work is supported by Iwata-Lab Department of Electrical and Computer Engineering, Nagoya Institute of Technology. The authors are thankful to the Hori Information Science Promotion Foundation for financial assistance.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jiang, Z., Yamauchi, K., Yoshioka, K. et al. Support Vector Machine-Based Feature Selection for Classification of Liver Fibrosis Grade in Chronic Hepatitis C. J Med Syst 30, 389–394 (2006). https://doi.org/10.1007/s10916-006-9023-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10916-006-9023-2