年龄、γ-谷氨酰转肽酶和血小板指数：一种用于预测乙型肝

StephenW

年龄、γ-谷氨酰转肽酶和血小板指数：一种用于预测乙型肝炎病毒相关肝硬化患者肝细胞癌的新型无创模型
      

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作者 刘克, 黄中, 杨 S, 林莉, 郑 S, 张 X, 薛毅, 谢维

2022 年 8 月 20 日收到

2022 年 10 月 5 日接受出版

2022 年 10 月 8 日出版第 2022 卷：9 第 1057-1063 页

DOI https://doi.org/10.2147/JHC.S386977

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批准出版的编辑：Ahmad O Kaseb 博士
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刘凯,1,2 黄泽宇,1 杨素华,1,2 林琳,1 郑淑琴,1,3 张秀军,1,3 袁雪,1,2 谢伟斌1,4

1常州市第三人民医院肝病研究所，常州市； 2中华人民共和国常州市第三人民医院感染科; 3中华人民共和国常州市第三人民医院肝病科； 4常州市第三人民医院麻醉科, 常州市

通讯作者：江苏省常州市兰陵北路300号常州市第三人民医院肝病研究所袁雪 邮编：213000 电话+86-0519 82009059 邮箱[email protected] 谢伟斌常州市第三人民医院麻醉科，江苏省常州市兰陵北路300号，213000，电话+86-0519 82008336，邮箱[email protected]

背景与目的：肝硬化（LC）患者存在高发肝细胞癌（HCC），但无创评分系统（NSS）的预测准确性尚待阐明。本研究旨在评估纤维化 4（FIB-4）、转氨酶与血小板比率指数（APRI）和 γ-谷氨酰转肽酶与血小板比率（GPR）对 LC 患者的预测能力，并建立精度更高的新模型。
方法：收集了 94 例代偿期 LC 患者和 134 例失代偿期肝硬化（DC）患者的数据。比较了包括 APRI、GPR 和 FIB-4 在内的 NSS 的预测精度。
结果：在 37.5 个月的中位随访期间，代偿 LC 组 9 例患者和 DC 组 38 例患者发展为 HCC。对于 228 名患者，APRI、GPR 和 FIB-4 的受试者工作特征曲线下面积（AUROC）分别为 0.596、0.625 和 0.654。多变量logistic分析显示，年龄、γ-谷氨酰转肽酶（GGT）和血小板（PLT）是HCC发生的独立危险因素，包含年龄、GGT和PLT的新模型优于NSSs（均P<0.05）。模型 (Age_GGT_PLT) 的最佳截止值为 0.216，灵敏度为 68.09%，特异性为 69.61%。
结论：NSSs，包括 APRI、GPR 和 FIB-4，在预测 HBV 相关 LC 患者的 HCC 发展方面具有非最佳准确性。因此，由年龄、GGT 和 PLT 组成的新模型可能比 NSS 更准确。

关键词：肝细胞癌，风险评分，肝硬化，失代偿期肝硬化，γ-谷氨酰转肽酶

StephenW

The Age, Gamma-Glutamyl Transpeptidase and Platelet Index: A Novel Noninvasive Model for Predicting Hepatocellular Carcinoma in Patients with Hepatitis B Virus-Related Liver Cirrhosis             Fulltext     Metrics     Get Permission     Cite this article  Authors Liu K, Huang Z, Yang S, Lin L, Zheng S, Zhang X, Xue Y , Xie W  Received 20 August 2022  Accepted for publication 5 October 2022  Published 8 October 2022 Volume 2022:9 Pages 1057—1063  DOI [url]https://doi.org/10.2147/JHC.S386977  Checked for plagiarism Yes  Review by Single anonymous peer review  Peer reviewer comments 2  Editor who approved publication: Dr Ahmad O Kaseb Download Article [PDF]    Kai Liu,1,2 Zeyu Huang,1 Suhua Yang,1,2 Lin Lin,1 Shuqin Zheng,1,3 Xiujun Zhang,1,3 Yuan Xue,1,2 Weibin Xie1,4  1Institute of Hepatology, the Third People’s Hospital of Changzhou, Changzhou, People’s Republic of China; 2Department of Infectious Diseases, the Third People’s Hospital of Changzhou, Changzhou, People’s Republic of China; 3Department of Liver Diseases, the Third People’s Hospital of Changzhou, Changzhou, People’s Republic of China; 4Department of Anesthesiology, the Third People’s Hospital of Changzhou, Changzhou, People’s Republic of China  Correspondence: Yuan Xue, Institute of Hepatology, the Third People’s Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, Jiangsu, 213000, People’s Republic of China, Tel +86-0519 82009059, Email [email protected] Weibin Xie, Department of Anesthesiology, The Third People’s Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, People’s Republic of China, Tel +86-0519 82008336, Email [email protected]  Background and Aims: High incidence of hepatocellular carcinoma (HCC) exists in patients with liver cirrhosis (LC), but the predictive accuracy of noninvasive scoring systems (NSSs) is yet to be elucidated. The present study aimed to evaluate the predictive ability of fibrosis-4 (FIB-4), aminotransferase-to-platelet ratio index (APRI), and gamma-glutamyl transpeptidase to platelet ratio (GPR) in patients with LC, and to establish a new model with more accuracy. Methods: Data from 94 patients with compensated LC and 134 patients with decompensated cirrhosis (DC) were collected. The prediction accuracy of NSSs, including APRI, GPR, and FIB-4, was compared. Results: During a median follow-up of 37.5 months, 9 patients in the compensated LC group and 38 in the DC group developed HCC. For 228 patients, the area under the receiver operating characteristic curve (AUROC) of APRI, GPR, and FIB-4 was 0.596, 0.625, and 0.654, respectively. Multivariable logistic analysis showed that age, gamma-glutamyl transpeptidase (GGT), and platelet (PLT) were independent risk factors for HCC development, and a new model encompassing age, GGT, and PLT was superior to NSSs (all P< 0.05). With an optimal cutoff value of 0.216, Model (Age_GGT_PLT) achieved 68.09% sensitivity and 69.61% specificity. Conclusion: NSSs, including APRI, GPR, and FIB-4, has a non-optimal accuracy in predicting HCC development in patients with HBV-related LC. Thus, the new model consisting of age, GGT, and PLT may be more accurate than NSSs.  Keywords: hepatocellular carcinoma, risk score, liver cirrhosis, decompensated cirrhosis, gamma-glutamyl transpeptidase

StephenW

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