The diagnostic value of non-invasive tests for the evaluation of liver fibrosis in chronic hepatitis B patients

被引:37
作者
Erdogan, Serpil [1 ]
Dogan, Halef Okan [1 ]
Sezer, Sevilay [1 ]
Uysal, Sema [1 ]
Ozhamam, Esra [2 ]
Kayacetin, Serra [2 ]
Koca, Yuksel [1 ]
机构
[1] Ankara Numune Training & Res Hosp, Dept Clin Biochem, Ankara, Turkey
[2] Ankara Numune Training & Res Hosp, Dept Clin Pathol, Ankara, Turkey
关键词
Alanine aminotransferase; aspartate aminotransferase; chronic hepatitis B; liver fibrosis; platelet count; PLATELET RATIO INDEX; PREDICTING SIGNIFICANT FIBROSIS; ROUTINE BLOOD-TESTS; C VIRUS-INFECTION; SERUM MARKERS; LABORATORY TESTS; HYALURONIC-ACID; CIRRHOSIS; DISEASE; MODEL;
D O I
10.3109/00365513.2013.773592
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background. Liver biopsy, which is considered the gold standard for the evaluation of hepatic fibrosis in patients with chronic hepatitis B (CHB), has certain limitations. The aim of this study was to investigate the diagnostic performance of non-invasive markers of hepatic fibrosis as potential alternatives to liver biopsy. Methods. The medical records of 221 patients with a diagnosis of CHB who underwent a liver biopsy were reviewed. Indirect indicators of fibrosis were calculated for each patient based on previously described formulas [Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AAR), age-platelet index (API), cirrhosis discriminant score (CDS), AST-platelet ratio index (APRI), Forns index, FIB-4, Pohl score, AAR-platelet score (AARP), fibro-quotient (FibroQ), AST/platelet/Gammaglutamyl transpeptidase (GGT)/Alphafetoprotein (AFP) (APGA) index, Platelet/Age/Phosphatase (ALP)/AFP/AST (PAPAS) index, Lok's model, Goteborg University Cirrhosis Index (GUCI)]. Diagnostic adequacy of these indices was evaluated by receiver operating characteristic curve analysis. Results. Area under the receiver operating characteristic curves for the FIB-4, Forns, GUCI, APRI, PAPAS, APGA and FibroQ indices were 0.701, 0.680, 0.670, 0.670, 0.639, 0.638 and 0.588, respectively. The AAR, API, CDS and AARP indices, Pohl score and Lok's model were all deemed diagnostically inadequate. FIB-4 had the best diagnostic adequacy whereas AAR had the worst. Conclusions. Our results suggest that out of the 13 indices evaluated, only FIB-4 index may be useful in estimating the extent of fibrosis in patients with CHB. There is a need for more comprehensive prospective studies to help determine the diagnostic value of non-invasive tests for liver fibrosis.
引用
收藏
页码:300 / 308
页数:9
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