Gastroenterol Hepatol. 2019 Feb 13. pii: S0210-5705(19)30025-1. doi: 10.1016/j.gastrohep.2018.12.004. [Epub ahead of print]
Comparison of non-invasive models for predicting liver damage in chronic hepatitis B patients.
[Article in English, Spanish]
Yu K1, Du Z2, Li Q3, Cheng Q1, Huang C1, Shi G1, Li N4.
Author information
1
Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China.
2
Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
3
Department of General Surgery, Qingdao Municipal Hospital, Qingdao 266071, China.
4
Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China. Electronic address: [email protected].
Abstract
INTRODUCTION:
Inexpensive blood tests have been well established as alternatives to liver biopsies to evaluate liver fibrosis in CHB patients. Here, we aim to compare their diagnostic accuracy in assessing liver fibrosis and necroinflammation.
PATIENTS AND METHODS:
A retrospective study was performed to evaluate the predictive value of non-invasive models in chronic hepatitis B patients with liver fibrosis by the area under receiver operating characteristic curve (AUROC). The clinical data of 160 patients were collected from medical records.
RESULTS:
Of the 160 consecutive treatment-naïve CHB patients, 29 (16%) had significant fibrosis and 34 (21%) had severe necroinflammation. The AUROC of the gamma-glutamyl transpeptidase to platelet ratio (GPR) (0.761, 95% CI 0.671-0.850) for predicting significant fibrosis was significantly higher than that of the aspartate transaminase-to-platelet ratio index (APRI) (0.680, 95% CI 0.585-0.774, p=0.034), but comparable with the fibrosis index based on four factors (Fib-4) (0.746, 95% CI 0.656-0.836, p=0.703), while for predicting severe necroinflammation, the performance of the GPR (AUROC=0.869, 95% CI 0.800-0.937) was better than the APRI (AUROC=0.816, 95% CI 0.740-0.892, p=0.085) and Fib-4 (0.792, 95% CI 0.711-0.873, p=0.023).
DISCUSSION:
GPR is a satisfactory model to stage liver fibrosis and to grade necroinflammation activity, representing a convenient non-invasive alternative to liver biopsy in China.