Xhemile Jusufi^1,2*, Sefedin Bilalli^2,3, Darko Serafimovski¹, Mimoza Bafqari-Bakiji^3,4, Fana Licoska Josifovic⁵, Arzana Hasani Jusufi⁵, Enfale Ismaili¹ and Marija Darkovska Serafimovska¹

¹Faculty of Medical Sciences, Goce Delcev University, Stip, North Macedonia
²University Institute of Clinical Biochemistry, Skopje, North Macedonia
³Faculty of Medical Sciences, University of Tetovo, North Macedonia
⁴Clinical Hospital of Tetovo, North Macedonia
⁵University Clinical Centre “Mother Teresa”, Clinic of Gastroenterohepatology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia

*Corresponding Author: Xhemile Jusufi, Faculty of Medical Sciences, Goce Delcev University, Stip, North Macedonia.

Received: July 27, 2026; Published: August 05, 2026

Liver fibrosis, as detected in progressive chronic liver diseases (CLD), can be defined as an excess deposition of extracellular matrix (ECM) components associated with parallel matrix degradation and remodelling. Liver fibrosis is the most important risk factor for the development of hepatocellular carcinoma (HCC) therefore accurate assessment of the degree of fibrosis is essential. Although liver biopsy is the gold standard, its invasiveness and high cost represent significant limitations, especially in the adult population. For this reason, non-invasive methods, including serum biomarkers and imaging techniques, are increasingly used in clinical practice as an initial screening approach. The aim of this study was to evaluate the diagnostic role of the Enhanced Liver Fibrosis test (ELF-score) in identifying and staging hepatic fibrosis, as well as to analyze its correlation with FibroScan as a non- invasive imaging method. The study included 60 patients with chronic liver disease and 20 participants as the control group, in whom the ELF score was determined by the measuring the following serological biomarkers: hyaluronic acid, amino-terminal propeptide of type III procollagen (PIIINP), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1). All patients also underwent a FibroScan examination to assess the severity of hepatic fibrosis. Statistical analysis, were performed using SPSS, version 26.0. The results showed a gradual increase in FibroScan values with increasing ELF score, reflecting a positive relationship between these two methods. A strong and statistically significant correlation was identified at the advanced stages of fibrosis, at the early stages the correlation was weaker.

Keywords: ELF Score; FibroScan; Liver Fibrosis; Non-Invasive Liver Fibrosis Test

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Citation

Citation: Xhemile Jusufi. et al. “Non-Invasive Assessment of Liver Fibrosis - ELF test (Enhanced Liver Fibrosis Blood Test) Compared with FibroScan". Acta Scientific Medical Sciences 10.9 (2026): 04-10.

Copyright

Copyright: © 2026 Xhemile Jusufi. et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.