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

• Main Author: ZHOU Xinlan
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2021-07-01
• Series: Linchuang Gandanbing Zazhi
• Online Access: http://www.lcgdbzz.org/cn/article/doi/10.3969/j.issn.1001-5256.2021.07.018

ObjectiveTo investigate the value of aspartate aminotransferase-to-platelet count ratio index (APRI), fibrosis-4 (FIB-4) score, gamma-glutamyl transpeptidase-to-platelet ratio (GPR), Gteborg University Cirrhosis Index (GUCI) score, and King’s score in assessing liver fibrosis stage in patients with chronic hepatitis B (CHB). MethodsA 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. ResultsThere 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. ConclusionAmong these five noninvasive models, GPR has the best diagnostic performance in determining liver fibrosis stage in patients with CHB.