GPR与APRI及FIB-4对慢性乙型肝炎肝纤维化程度的预测价值比较

StephenW

J Viral Hepat. 2017 Dec 12. doi: 10.1111/jvh.12842. [Epub ahead of print]
Comparative evaluation of GPR versus APRI and FIB-4 in predicting different levels of liver fibrosis of chronic hepatitis B.Liu DP1, Lu W1, Zhang ZQ1, Wang YB1, Ding RR1, Zhou XL1, Huang D1, Li XF1.
Author information
1Department of Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.

AbstractIt is of great significance to develop and evaluate noninvasive indexes predicting the level of liver fibrosis. The aim of this study was to comparatively evaluate gamma-glutamyl transpeptidase-to-platelet ratio (GPR) versus aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on 4 factors (FIB-4) in predicting different levels of liver fibrosis of chronic hepatitis B (CHB) within the framework of HBeAg-positive and HBeAg-negative patients. 1157 HBeAg-positive and 859 HBeAg-negative CHB patients were enrolled, among whom the pathological stage ≥S2, ≥S3, ≥ S4 were defined as significant fibrosis, extensive fibrosis and cirrhosis, respectively. Receiver operating characteristic (ROC) curves were used to evaluate the performance of GPR, APRI and FIB-4 in predicting different levels of liver fibrosis. In HBeAg-positive patients, the area under ROC curves (AUROCs) of GPR in predicting extensive fibrosis and cirrhosis were both significantly larger than those of APRI (P=0.0001 and P<0.0001). In HBeAg-negative patients, the AUROCs of GPR in predicting significant fibrosis and cirrhosis were significantly larger than those of FIB-4 (P=0.0006 and P=0.0041). The AUROC of GPR in predicting extensive fibrosis was significantly larger than that of APRI and FIB-4 (P=0.0320 and P=0.0018). Using a cutoff of GPR >0.500 as standard, the sensitivities and specificities of GPR in predicting significant fibrosis in HBeAg-positive patients were 59.6% and 81.2%, and for cirrhosis 80.9% and 63.8%, respectively; and those of HBeAg-negative patients were 60.3% and 78.3%, 84.5% and 66.1%, respectively. Regardless of HBeAg-positive or HBeAg-negative status, GPR had the best performance in predicting different levels of liver fibrosis. This article is protected by copyright. All rights reserved.


KEYWORDS: aspartate aminotransferase-to-platelet ratio index; chronic hepatitis B; fibrosis; fibrosis index based on the 4 factors; gamma-glutamyl transpeptidase-to-platelet ratio; noninvasive diagnosis

PMID:29230907DOI:10.1111/jvh.12842

StephenW

J病毒肝脏。 2017 Dec 12。doi：10.1111 / jvh.12842。 [电子版提前打印]
GPR与APRI及FIB-4对慢性乙型肝炎肝纤维化程度的预测价值比较
Liu DP1，Lu W1，Zhang ZQ1，Wang YB1，Ding RR1，Zhou XL1，Huang D1，Li XF1。
作者信息

1
    上海复旦大学上海市公共卫生临床中心肝病科。

抽象

开发和评价预测肝纤维化水平的无创指标具有重要意义。这项研究的目的是比较评估γ-谷氨酰转肽酶 - 血小板比率（GPR）与天冬氨酸转氨酶 - 血小板比值指数（APRI）和纤维化指数基于4个因素（FIB-4）预测不同水平的慢性乙型肝炎（CHB）在HBeAg阳性和HBeAg阴性患者框架内的肝纤维化。纳入1157例HBeAg阳性和859例HBeAg阴性慢性乙型肝炎患者，其中病理分期≥S2，≥S3，≥S4分别为重度纤维化，广泛纤维化和肝硬化。采用受试者工作特征（ROC）曲线评估GPR，APRI和FIB-4在预测不同水平肝纤维化中的表现。在HBeAg阳性患者中，GPR预测广泛纤维化和肝硬化的ROC曲线下面积（AUROCs）显着大于APRI（P = 0.0001和P <0.0001）。在HBeAg阴性患者中，GPR预测显着纤维化和肝硬化的AUROCs显着大于FIB-4（P = 0.0006和P = 0.0041）。 GPR在预测广泛纤维化中的AUROC显着大于APRI和FIB-4（P = 0.0320和P = 0.0018）。以GPR> 0.500为界标准，GPR预测HBeAg阳性患者纤维化的敏感性和特异性分别为59.6％和81.2％，肝硬化分别为80.9％和63.8％; HBeAg阴性患者分别为60.3％和78.3％，84.5％和66.1％。无论HBeAg阳性还是HBeAg阴性，GPR在预测不同水平的肝纤维化方面表现最佳。本文受版权保护。版权所有。
关键词：

天冬氨酸转氨酶 - 血小板比指数;慢性乙型肝炎;纤维化;基于4个因子的纤维化指数; γ-谷氨酰转肽酶 - 血小板比率;无创诊断

结论：
    29230907
DOI：
    10.1111 / jvh.12842