Scand J Gastroenterol. 2019 Jan 20:1-6. doi: 10.1080/00365521.2018.1558786. [Epub ahead of print]
Predictive value of the red blood cell distribution width-to-platelet ratio for hepatic fibrosis.
Yuyun D1, Zhihua T2, Haijun W3, Zhaoping L4, Xiaoli Z5, Wenfang X6, Faxiang J6, Hongmei L6.
Author information
1
a Department of Laboratory Medicine , The Affiliated Hospital of Shaoxing University , Shaoxing , China.
2
b Department of Laboratory Medicine , The Second Affiliated Hospital of Zhejiang University School of Medicine Laboratory Medicine , Hangzhou , China.
3
c Department of Pathology , The Second Affiliated Hospital of Zhejiang University School of Medicine , Hangzhou , China.
4
d Department of Blood transfusion , The Second Affiliated Hospital of Zhejiang University School of Medicine , Hangzhou , China.
5
e Department of Laboratory Medicine , Taizhou Hospital of Zhejiang Province , Linhai City , China.
6
f Department of Laboratory Medicine , The Affiliated Hospital of Shaoxing University , Shaoxing , China.
Abstract
AIMS:
The red blood cell distribution width-to-platelet ratio (RPR) has been reported to be an indicator of hepatic fibrosis in patients with chronic hepatitis B (HBV), nonalcoholic fatty liver disease (NAFLD) or chronic hepatitis C (HCV). However, no research has explored the RPR in all patients with hepatic fibrosis. There is a recognized need to establish whether the RPR could assess hepatic fibrosis and reflect the severity of fibrosis, regardless of the patient's etiology.
METHODS:
Quantitative data from 1282 patients who underwent liver biopsy between January 2010 and December 2014 at the Second Affiliated Hospital of Zhejiang University School of Medicine were included. The etiologies included HBV or HCV infection, NAFLD, schistosomiasis, granulomatous liver disease, and vascular abnormalities. Five noninvasive models were calculated for all patients based on laboratory parameters. The degrees of fibrosis severity were evaluated based on the Metavir scoring scale.
RESULTS:
The RPR demonstrated the best accuracy of predicting hepatic fibrosis among the selected five models (0.75, p < .001) regardless of etiology. In addition, the RPR values increased with advanced hepatic fibrosis progression. Furthermore, combining the RPR with the white blood cell (WBC) count improved the accuracy of grading hepatic fibrosis as reflected by the likelihood ratio (LR + 9.03, LR - 0.49).
CONCLUSION:
The RPR is a useful indicator for hepatic fibrosis, regardless of etiology, and can reflect the severity of fibrosis. This study supports further clinical development of the RPR both in a stepwise manner or in combination with inflammatory parameters to improve the accuracy of scoring hepatic fibrosis.
KEYWORDS: