Original scientific paper
https://doi.org/10.3325/cmj.2015.56.272
Performance of several simple, noninvasive models for assessing significant liver fibrosis in patients with chronic hepatitis B
Xianghua Zeng
; Department for Infectious Diseases, Southwest Hospital Third Military Medical University, Chongqing, People’s Republic of China
Cheng Xu
; Chongqing Key Laboratory of Research of Infectious Diseases, Chongqing, People’s Republic of China
Dengming He
; Liver Disease Diagnosis and Treatment Center, 88th Hospital of Chinese People’s Liberation Army, Tai’an, People’s Republic of China
Maoshi Li
; 77608 Troops of Chinese People’s Liberation Army, Lhasa, Tibet
Huiyan Zhang
; Department for Infectious Diseases, Southwest Hospital Third Military Medical University, Chongqing, People’s Republic of China
Quanxin Wu
; Department for Infectious Diseases, Southwest Hospital Third Military Medical University, Chongqing, People’s Republic of China
Dedong Xiang
; Department for Infectious Diseases, Southwest Hospital Third Military Medical University, Chongqing, People’s Republic of China
Yuming Wang
; Department for Infectious Diseases, Southwest Hospital Third Military Medical University, Chongqing, People’s Republic of China
Abstract
Aim To compare the performance of several simple, noninvasive
models comprising various serum markers in diagnosing
significant liver fibrosis in the same sample of
patients with chronic hepatitis B (CHB) with the same judgment
standard.
Methods A total of 308 patients with CHB who had undergone
liver biopsy, laboratory tests, and liver stiffness
measurement (LSM) at the Southwest Hospital, Chongqing,
China between March 2010 and April 2014 were retrospectively
studied. Receiver operating characteristic (ROC)
curves and area under ROC curves (AUROCs) were used to
analyze the results of the models, which incorporated ageplatelet
(PLT) index (API model), aspartate transaminase
(AST) to alanine aminotransferase (ALT) ratio (AAR model),
AST to PLT ratio index (APRI model), γ-glutamyl transpeptidase
(GGT) to PLT ratio index (GPRI model), GGT-PLT-albumin
index (S index model), age-AST-PLT-ALT index (FIB-4
model), and age-AST-PLT-ALT-international normalized ratio
index (Fibro-Q model).
Results The AUROCs of the S index, GPRI, FIB-4, APRI, API,
Fibro-Q, AAR, and LSM for predicting significant liver fibrosis
were 0.726 (P < 0.001), 0.726 (P < 0.001), 0.621 (P = 0.001),
0.619 (P = 0.001), 0.580 (P = 0.033), 0.569 (P = 0.066), 0.495
(P = 0.886), and 0.757 (P < 0.001), respectively. The S index
and GPRI had the highest correlation with histopathological
scores (r = 0.373, P < 0.001; r = 0.372, P < 0.001, respectively)
and LSM values (r = 0.516, P < 0.001; r = 0.513,
P < 0.001, respectively). When LSM was combined with S
index and GPRI, the AUROCs were 0.753 (P < 0.001) and
0.746 (P < 0.001), respectively.
Conclusion S index and GPRI had the best diagnostic performance
for significant liver fibrosis and were robust predictors
of significant liver fibrosis in patients with CHB for
whom transient elastography was unavailable.
Keywords
Hrčak ID:
151330
URI
Publication date:
15.6.2015.
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