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
刘凯 1 2 , 黄泽宇 1 , 杨素华 1 2 , 林琳 1 , 郑淑琴 1 3 , 张秀君 1 3 , 袁雪 1 2 , 谢伟斌 1 4
隶属关系
隶属关系

    1
    【作者单位】： 常州市第三人民医院肝病研究所;
    2
    【作者单位】： 常州市第三人民医院感染科;
    3
    【作者单位】： 常州市第三人民医院肝病科;
    4
    【作者单位】： 常州市第三人民医院麻醉科;

    PMID：36250136 PMCID：PMC9555219 DOI：10.2147/JHC.S386977

抽象的

背景和目的：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：失代偿期肝硬化； γ-谷氨酰转肽酶；肝细胞癌;肝硬化;风险评分。

© 2022 刘等人。
利益冲突声明

作者声明他们没有相互竞争的利益。

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
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 Xie  1   4
Affiliations
Affiliations

    1
    Institute of Hepatology, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China.
    2
    Department of Infectious Diseases, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China.
    3
    Department of Liver Diseases, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China.
    4
    Department of Anesthesiology, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China.

    PMID: 36250136 PMCID: PMC9555219 DOI: 10.2147/JHC.S386977

Abstract

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: decompensated cirrhosis; gamma-glutamyl transpeptidase; hepatocellular carcinoma; liver cirrhosis; risk score.

© 2022 Liu et al.
Conflict of interest statement

The authors declare that they have no competing interests.

StephenW

https://www.dovepress.com/getfile.php?fileID=84519