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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 7
Jul.  2021
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Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(7): 1567-1571

Value of five noninvasive serum models in the diagnosis of chronic hepatitis B liver fibrosis

DOI: 10.3969/j.issn.1001-5256.2021.07.018

  • Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Shanghai 201508, China

Research funding:

Shanghai Public Health Clinical Center Hospital-level Funding (KSF0576)

  • Received Date: 2020-12-04
  • Accepted Date: 2020-12-29
  • Published Date: 2021-07-20
    Abstract
  •   Objective  To investigate the value of aspartate aminotransferase-to-platelet count ratio index (APRI), fibrosis-4 (FIB-4) score, gamma-glutamyl transpeptidase-to-platelet ratio (GPR), Göteborg University Cirrhosis Index (GUCI) score, and King's score in assessing liver fibrosis stage in patients with chronic hepatitis B (CHB).  Methods  A total of 612 patients with CHB who were hospitalized in Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, from January 2016 to December 2018 and underwent liver biopsy and routine laboratory examinations were enrolled. The Scheuer method was used to determine inflammation grade (G) and fibrosis stage (S), and related clinical indicators were used to calculate APRI, FIB-4, GPR, GUCI score, and King's score. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. A Spearman correlation analysis was used to investigate the correlation between two variables, and the area under the ROC curve (AUC) was used to compare diagnostic performance.  Results  There were significant differences in GPR, APRI, FIB-4, King's score, and GUCI score between the patients with S1-S2 fibrosis and those with S3-S4 fibrosis (Z=8.683, 7.372, 6.294, 7.204, and 7.795, all P < 0.001). GPR, APRI, FIB-4, King's score, and GUCI score were all positively correlated with liver fibrosis stage (r=0.54, 0.48, 0.44, 0.48, and 0.49, all P < 0.001). In the diagnosis of ≥S2, ≥S3, and S4 liver fibrosis, GPR had AUCs of 0.76, 0.80, and 0.82, respectively; APRI had AUCs of 0.75, 0.75, and 0.74, respectively; FIB-4 had AUCs of 0.70, 0.75 and 0.78, respectively; King's score had AUCs of 0.74, 0.76, and 0.77, respectively; GUCI had AUCs of 0.75, 0.76, and 0.76, respectively.  Conclusion  Among these five noninvasive models, GPR has the best diagnostic performance in determining liver fibrosis stage in patients with CHB.

     

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    • References(26)
  • [1]
    RAPTOPOULOU M, PAPATHEODORIDIS G, ANTONIOU A, et al. Epidemiology, course and disease burden of chronic hepatitis B virus infection. HEPNET study for chronic hepatitis B: A multicentre Greek study[J]. J Viral Hepat, 2009, 16(3): 195-202. DOI: 10.1111/j.1365-2893.2008.01057.x.
    [2]
    LIANG P, ZU J, YIN J, et al. The independent impact of newborn hepatitis B vaccination on reducing HBV prevalence in China, 1992-2006: A mathematical model analysis[J]. J Theor Biol, 2015, 386: 115-121. DOI: 10.1016/j.jtbi.2015.08.030.
    [3]
    European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection[J]. J Hepatol, 2017, 67(2): 370-398. DOI: 10.1016/j.jhep.2017.03.021.
    [4]
    LAMPERTICO P, INVERNIZZI F, VIGANÒ M, et al. The long-term benefits of nucleos(t)ide analogs in compensated HBV cirrhotic patients with no or small esophageal varices: A 12-year prospective cohort study[J]. J Hepatol, 2015, 63(5): 1118-1125. DOI: 10.1016/j.jhep.2015.06.006.
    [5]
    KIM WR, LOOMBA R, BERG T, et al. Impact of long-term tenofovir disoproxil fumarate on incidence of hepatocellular carcinoma in patients with chronic hepatitis B[J]. Cancer, 2015, 121(20): 3631-3638. DOI: 10.1002/cncr.29537.
    [6]
    LEE HW, YOO EJ, KIM BK, et al. Prediction of development of liver-related events by transient elastography in hepatitis B patients with complete virological response on antiviral therapy[J]. Am J Gastroenterol, 2014, 109(8): 1241-1249. DOI: 10.1038/ajg.2014.157.
    [7]
    SEO YS, KIM MY, KIM SU, et al. Accuracy of transient elastography in assessing liver fibrosis in chronic viral hepatitis: A multicentre, retrospective study[J]. Liver Int, 2015, 35(10): 2246-2255. DOI: 10.1111/liv.12808.
    [8]
    CHENG DY, WANG XM, OU WN, et al. Application of transient elastography in non-invasive diagnosis of liver fibrosis in patients with non-viral liver diseases[J/CD]. Chin J Liver Dis(Electronic Edition), 2019, 11(1): 37-41. DOI: 10.3969/j.issn.1674-7380.2019.01.007.

    程丹颖, 王笑梅, 欧蔚妮, 等. 瞬时弹性成像技术在非病毒性肝病肝纤维化无创诊断中的应用[J/CD]. 中国肝脏病杂志(电子版), 2019, 11(1): 37-41. DOI: 10.3969/j.issn.1674-7380.2019.01.007.
    [9]
    CASTERA L. Noninvasive methods to assess liver disease in patients with hepatitis B or C[J]. Gastroenterology, 2012, 142(6): 1293-1302. e4. DOI: 10.1053/j.gastro.2012.02.017.
    [10]
    THANDASSERY RB, AL KAABI S, SOOFI ME, et al. Mean platelet volume, red cell distribution width to platelet count ratio, globulin platelet index, and 16 other indirect noninvasive fibrosis scores: How much do routine blood tests tell about liver fibrosis in chronic hepatitis C?[J]. J Clin Gastroenterol, 2016, 50(6): 518-523. DOI: 10.1097/MCG.0000000000000489.
    [11]
    LEMOINE M, SHIMAKAWA Y, NAYAGAM S, et al. The gamma-glutamyl transpeptidase to platelet ratio (GPR) predicts significant liver fibrosis and cirrhosis in patients with chronic HBV infection in West Africa[J]. Gut, 2016, 65(8): 1369-1376. DOI: 10.1136/gutjnl-2015-309260.
    [12]
    WANG RQ, ZHANG QS, ZHAO SX, et al. Gamma-glutamyl transpeptidase to platelet ratio index is a good noninvasive biomarker for predicting liver fibrosis in Chinese chronic hepatitis B patients[J]. J Int Med Res, 2016, 44(6): 1302-1313. DOI: 10.1177/0300060516664638.
    [13]
    Chinese Society of Hepatology and Chinese Society of infectious Diseases, Chinese Medical Association. The guideline of prevention and treatment for chronic hepatitis B: A 2015 update[J]. J Cin Hepatol, 2015, 31(12): 1941 -1960. DOI: 10.3969/j.issn.1001-5256.2015.12.002.

    中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2015年更新版)[J]. 临床肝胆病杂志, 2015, 31(12): 1941-1960. DOI: 10.3969/j.issn.1001-5256.2015.12.002.
    [14]
    SCHEUER PJ. The nomenclature of chronic hepatitis: Time for a change[J]. J Hepatol, 1995, 22(1): 112-114. DOI: 10.1016/0168-8278(95)80269-x.
    [15]
    ZENG DW, DONG J, LIU YR, et al. Noninvasive models for assessment of liver fibrosis in patients with chronic hepatitis B virus infection[J]. World J Gastroenterol, 2016, 22(29): 6663-6672. DOI: 10.3748/wjg.v22.i29.6663.
    [16]
    SARIN SK, KUMAR M, LAU GK, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: A 2015 update[J]. Hepatol Int, 2016, 10(1): 1-98. DOI: 10.1007/s12072-015-9675-4.
    [17]
    TERRAULT NA, BZOWEJ NH, CHANG KM, et al. AASLD guidelines for treatment of chronic hepatitis B[J]. Hepatology, 2016, 63(1): 261-283. DOI: 10.1002/hep.28156.
    [18]
    GONG H, LI LP. Value of Fibroscan combined with GPR, APRI, NFS or FIB-4 for progressive liver fibrosis in patients with chronic hepatitis B and nonalcoholic fatty liver disease[J]. J Clin Hepatol, 2020, 36(3): 541-545. DOI: 10.3969/j.issn.1001-5256.2020.03.014.

    龚航, 李良平. FibroScan分别与GPR、APRI、NFS、FIB-4联合应用对慢性乙型肝炎合并非酒精性脂肪性肝病进展期肝纤维化的诊断价值比较[J]. 临床肝胆病杂志, 2020, 36 (3): 541-545. DOI: 10.3969/j.issn.1001-5256.2020.03.014.
    [19]
    ZHU MY, ZOU X, LI Q, et al. A novel noninvasive algorithm for the assessment of liver fibrosis in patients with chronic hepatitis B virus infection[J]. J Viral Hepat, 2017, 24(7): 589-598. DOI: 10.1111/jvh.12682.
    [20]
    CHENG JL, WANG XL, YANG SG, et al. Non-ALT biomarkers for markedly abnormal liver histology among Chinese persistently normal alanine aminotransferase-chronic hepatitis B patients[J]. World J Gastroenterol, 2017, 23(15): 2802-2810. DOI: 10.3748/wjg.v23.i15.2802.
    [21]
    GIANNINI E, CEPPA P, BOTTA F, et al. Steatosis and bile duct damage in chronic hepatitis C: Distribution and relationships in a group of Northern Italian patients[J]. Liver, 1999, 19(5): 432-437. DOI: 10.1111/j.1478-3231.1999.tb00074.x.
    [22]
    NILSSEN O, FØRDE OH. Seven-year longitudinal population study of change in gamma-glutamyltransferase: The troms study[J]. Am J Epidemiol, 1994, 139(8): 787-792. DOI: 10.1093/oxfordjournals.aje.a117075.
    [23]
    XU XY, KONG H, SONG RX, et al. The effectiveness of noninvasive biomarkers to predict hepatitis B-related significant fibrosis and cirrhosis: A systematic review and meta-analysis of diagnostic test accuracy[J]. PLoS One, 2014, 9(6): e100182. DOI: 10.1371/journal.pone.0100182.
    [24]
    XIAO G, YANG J, YAN L. Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis-4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: A systemic review and meta-analysis[J]. Hepatology, 2015, 61(1): 292-302. DOI: 10.1002/hep.27382.
    [25]
    CHOU R, WASSON N. Blood tests to diagnose fibrosis or cirrhosis in patients with chronic hepatitis C virus infection[J]. Ann Intern Med, 2013, 159(5): 372. DOI: 10.7326/0003-4819-159-5-201309030-00021.
    [26]
    EMINLER AT, AYYILDIZ T, IRAK K, et al. AST/ALT ratio is not useful in predicting the degree of fibrosis in chronic viral hepatitis patients[J]. Eur J Gastroenterol Hepatol, 2015, 27(12): 1361-1366. DOI: 10.1097/MEG.0000000000000468.
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