Oncotarget. 2017 Apr 27. doi: 10.18632/oncotarget.17470. [Epub ahead of print]
Impact of age on the diagnostic performances and cut-offs of APRI and FIB-4 for significant fibrosis and cirrhosis in chronic hepatitis B.
Li Q1,2, Lu C1, Li W1, Huang Y1,2, Chen L1.
Author information
1 Department of Hepatitis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
2 Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China.
Abstract
AIMS:
Assessing the diagnostic performances of APRI and FIB-4 using age as a categorical marker.
METHODS:
822 chronic hepatitis B (CHB) patients were included. Using METAVIR scoring system as a reference, the performances of APRI and FIB-4 were compared between patients aged≥30 and patients aged<30 years.
RESULTS:
The APRI AUROC in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (0.61 vs 0.70, p<0.001) and cirrhosis (0.64 vs 0.78, p<0.001). The FIB-4 AUROC in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (0.57 vs 0.65, p<0.001) and cirrhosis (0.63 vs 0.72, p<0.001). Using specificity≥90%, the APRI cut-off in patients aged<30 years was lower than patients aged≥30 years for significant fibrosis (1.0 vs 1.2) and cirrhosis (1.2 vs 1.5). Using sensitivity≥90%, the APRI cut-off in patients aged<30 years was also lower than patients aged≥30 years for significant fibrosis (0.2 vs 0.4) and cirrhosis (0.3 vs 0.5). Using specificity≥90%, the FIB-4 cut-off in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (1.2 vs 2.1) and cirrhosis (1.4 vs 2.6). Using sensitivity≥90%, the FIB-4 cut-off in patients aged<30 years was also lower than that in patients aged≥30 years for significant fibrosis (0.5 vs 0.8) and cirrhosis (0.8 vs 1.2).
CONCLUSIONS:
Evaluation of the diagnostic performances of APRI and FIB-4 should take age into consideration.
KEYWORDS:
年龄<30岁的患者APRI AUROC低于30岁以上患者显着纤维化(0.61 vs 0.70,p <0.001)和肝硬化(0.64 vs 0.78,p <0.001)。 30岁以下患者的FIB-4 AUROC低于30岁以上的纤维化患者(0.57 vs 0.65,p <0.001)和肝硬化(0.63 vs 0.72,p <0.001)。使用特异度≥90%,APRI在30岁以下患者中的临界值低于30岁以上,显着纤维化(1.0 vs 1.2)和肝硬化(1.2 vs 1.5)。使用灵敏度≥90%,APRI在30岁以下患者中的临界值也低于30岁以上,明显的纤维化(0.2 vs 0.4)和肝硬化(0.3 vs 0.5)。使用特异度≥90%,30岁以下患者的FIB-4临界值低于30岁以上患者明显纤维化(1.2 vs 2.1)和肝硬化(1.4 vs 2.6)。使用灵敏度≥90%时,30岁以下患者的FIB-4临界值也低于30岁以上患者,显着纤维化(0.5 vs 0.8)和肝硬化(0.8 vs 1.2)。
结论: