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HelpTest Code ELF Enhanced Liver Fibrosis (ELF), Serum
Specimen Required
Patient Preparation: For 12 hours before specimen collection, patient should not take multivitamins or dietary supplements (eg, hair, skin, and nail supplements) containing biotin (vitamin B7).
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL Serum
Collection Instructions: Within 2 hours of collection, centrifuge and aliquot serum into a plastic vial. Specimens that have not been aliquoted will be rejected.
Forms
If not ordering electronically, complete, print, and send Gastroenterology and Hepatology Test Request (T728) with the specimen.
Useful For
As a prognostic marker in conjunction with other laboratory findings and clinical assessments to assess the likelihood of progression to cirrhosis and liver-related clinical events in patients with advanced fibrosis (F3 or F4) due to metabolic dysfunction-associated steatohepatitis (MASH)
Method Name
Direct Chemiluminescent Immunoassay
Reporting Name
ELF (Enhanced Liver Fibrosis), SSpecimen Type
SerumSpecimen Minimum Volume
Serum: 0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 7 days |
| Frozen | 365 days | |
| Ambient | 48 hours |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Reference Values
|
ELF score |
Risk of disease progression |
|
≥9.20 |
Diagnostic cut-off for clinically significant fibrosis (fibrosis stage 2 or greater) |
|
≥11.30 |
Prognostic cut-off for higher risk of progression to liver-related clinical events |
Interpretation
A prognostic risk assessment using the enhanced liver fibrosis (ELF) score, in conjunction with other laboratory findings and clinical assessments, may be useful in determining which patients could benefit from additional examinations, increased monitoring, and potential lifestyle changes and treatment interventions.
The ELF score quantifies analytes that are components of the extracellular matrix (ECM), which directly contribute to liver fibrosis. Hyaluronic acid, a glycosaminoglycan produced by hepatic stellate cells, is an essential component within the connective matrix. Amino-terminal propeptide of type III procollagen (PIIINP), produced by fibroblasts in the liver, is a marker of fibrogenesis and inflammation. Tissue inhibitor of matrix metalloproteinase 1 is a circulating inhibitor of matrix metalloproteinase enzymes that can inhibit fibrolysis and fibrosis repair. Together, these analytes reflect qualitative and quantitative changes in the ECM associated with progression of liver disease.
The ELF score is a prognostic marker for patients with advanced fibrosis (F3 or F4) due to metabolic dysfunction-associated steatohepatitis. ELF is used to assess the risk of progression to cirrhosis and future liver-related clinical events up to 3.9 years following baseline ELF score.
Day(s) Performed
Monday through Friday
Report Available
Same day/1 to 3 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
81517
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ELF | ELF (Enhanced Liver Fibrosis), S | 88055-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| ELFSC | ELF Score | 88055-9 |