| A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
Enhanced Liver Fibrosis (ELF) Score [10350X]
Test CodeELFS
Quest Code
103501
CPT Codes
81517
Preferred Specimen
1 mL serum
Minimum Volume
0.5 mL
Instructions
Spin sample within two hours after collection.
Dietary supplements containing biotin may interfere in assays and may skew analyte results to be either falsely high or falsely low. For patients receiving the recommended daily doses of biotin, draw samples at least 8 hours following the last biotin supplementation. For patients on mega-doses of biotin supplements, draw samples at least 72 hours following the last biotin supplementation.
Samples with fluorescein may cause falsely depressed results. Evidence suggests that patients undergoing retinal fluorescein angiography can retain amounts of fluorescein in the body for up to 72 hours post-treatment.
Dietary supplements containing biotin may interfere in assays and may skew analyte results to be either falsely high or falsely low. For patients receiving the recommended daily doses of biotin, draw samples at least 8 hours following the last biotin supplementation. For patients on mega-doses of biotin supplements, draw samples at least 72 hours following the last biotin supplementation.
Samples with fluorescein may cause falsely depressed results. Evidence suggests that patients undergoing retinal fluorescein angiography can retain amounts of fluorescein in the body for up to 72 hours post-treatment.
Transport Temperature
Refrigerated (cold packs)
Specimen Stability
Room temperature: 48 hours
Refrigerated: 7 days
Frozen: 30 days
Refrigerated: 7 days
Frozen: 30 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis
Methodology
Chemiluminescent Immunoassay
Setup Schedule
Set up: Tues, Thurs, Sat; Report available: 3-4 days
Reference Range
<9.80
ELF score ranges and associated risk of disease progression (development of cirrhosis or liver-related events):
ELF score ranges and associated risk of disease progression (development of cirrhosis or liver-related events):
| <9.80 | Lower |
| ≥9.80 - <11.30 | Mid |
| ≥11.30 | Higher |
Clinical Significance
The Enhanced Liver Fibrosis (ELF) score predicts progression to cirrhosis and liver-related events in patients with advanced fibrosis due to NASH.
The ELF score is not for use in the diagnosis of NASH, the staging of fibrosis, the serial monitoring of disease progression, or the monitoring of effects of therapeutic products.
The ELF score is derived from an algorithm that combines measurements of PIIINP, TIMP-1, and HA. PIIINP is a marker of early fibrogenesis and inflammation, TIMP-1 is the circulating inhibitor of MMP enzymes that can enhance fibrogenesis, and HA is a glycosaminoglycan that is produced by hepatic stellate cells. Together, these assays measure qualitative and quantitative changes in the extracellular matrix (ECM). The ECM refers to a set of macromolecules that comprise the extracellular scaffolding of the liver. Some ECM markers reflect fibrogenesis and others reflect fibrosis regression, allowing for a dynamic evaluation of ECM activity.
The ELF score is not for use in the diagnosis of NASH, the staging of fibrosis, the serial monitoring of disease progression, or the monitoring of effects of therapeutic products.
The ELF score is derived from an algorithm that combines measurements of PIIINP, TIMP-1, and HA. PIIINP is a marker of early fibrogenesis and inflammation, TIMP-1 is the circulating inhibitor of MMP enzymes that can enhance fibrogenesis, and HA is a glycosaminoglycan that is produced by hepatic stellate cells. Together, these assays measure qualitative and quantitative changes in the extracellular matrix (ECM). The ECM refers to a set of macromolecules that comprise the extracellular scaffolding of the liver. Some ECM markers reflect fibrogenesis and others reflect fibrosis regression, allowing for a dynamic evaluation of ECM activity.
Performing Laboratory
| Quest Diagnostics Nichols Institute-San Juan Capistrano, CA |
| 33608 Ortega Highway |
| San Juan Capistrano, CA 92675-2042 |
Last Updated: July 6, 2023
