Evaluation and comparison of the diagnostic performance of routine blood tests in predicting liver fibrosis in chronic hepatitis B infection

被引:14
作者
Lu, W. [1 ]
Zhang, Y. P. [1 ]
Zhu, H. G. [1 ]
Zhang, T. [1 ]
Zhang, L. [1 ]
Gao, N. [1 ]
Chang, D. Y. [2 ]
Yin, J. [1 ]
Zhou, X. Y. [1 ]
Li, M. Y. [3 ,4 ]
Li, Y. T. [5 ,6 ]
Li, Z. Z. [1 ]
He, Q. [1 ]
Geng, Y. [1 ]
机构
[1] Xi An Jiao Tong Univ, Affiliated Hosp 2, Dept Lab, Xian 710004, Shaanxi, Peoples R China
[2] Xi An Jiao Tong Univ, Affiliated Hosp 2, Dept Gastroenterol & Hepatol, Xian, Shaanxi, Peoples R China
[3] Peking Univ, Hlth Sci Ctr, Dept Microbiol, Beijing, Peoples R China
[4] Peking Univ, Hlth Sci Ctr, Ctr Infect Dis, Beijing, Peoples R China
[5] Fudan Univ, Shanghai Med Coll, Key Lab Med Mol Virol, Minist Hlth, Shanghai, Peoples R China
[6] Fudan Univ, Shanghai Med Coll, Key Lab Med Mol Virol, Minist Educ, Shanghai, Peoples R China
关键词
Chronic hepatitis B infection; liver fibrosis; transient elastography; non-invasive marker; GAMMA-GLUTAMYL-TRANSPEPTIDASE; PLATELET RATIO; TRANSIENT ELASTOGRAPHY; CIRRHOSIS; ACCURACY; BIOPSY; INDEX; FIB-4;
D O I
10.1080/09674845.2019.1615717
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Background & aims: Biopsy is the gold standard for staging liver fibrosis, but it may be accompanied by complications. As an alternative, non-invasive markers such as transient elastography (for liver fibrosis) and certain combinations of routine blood markers (liver function tests, full blood count) have been developed although their clinical significance remains controversial. Here, we compare the diagnostic values of non-invasive markers for liver fibrosis in patients with chronic hepatitis B infection. Methods: Transient elastography and routine laboratory tests were performed in 196 patients. Diagnostic performances were compared and were assessed based on the area under the curve (AUC) of a receiver operating characteristic (ROC) analysis. Results: Elevated GGT to platelet ratio (GPR), the fibrosis index FIB-4 [based on age, AST, platelets and ALT], platelet to lymphocyte ratio (PLR) and total bilirubin were independent predictors of liver stiffness defined by transient elastography (all P < 0.001). The AUCs of GPR in predicting both advanced fibrosis and cirrhosis were significantly larger than that of FIB-4 (P = 0.037 and P = 0.008, respectively) and AST-to-platelet ratio index (APRI) (P = 0.008 and P = 0.005). FIB-4, APRI and red cell volume distribution width-to-platelet ratio (RPR) had similar diagnostic values in discriminating different levels of liver fibrosis. Conclusions: GPR showed the best diagnostic value and RPR and PLR are easily available and inexpensive markers in evaluating fibrosis and cirrhosis. The diagnostic values of these laboratory markers are useful in diagnosing advanced fibrosis or cirrhosis, and in confirming the different levels of liver fibrosis.
引用
收藏
页码:137 / 142
页数:6
相关论文
共 33 条
[1]  
[Anonymous], 2015, J HEPATOL, V63, P237, DOI 10.1016/j.jhep.2015.04.006
[2]  
[Anonymous], 2015, GUIDELINES PREVENTIO
[3]   Noninvasive assessment of liver damage in chronic hepatitis B [J].
Celikbilek, Mehmet ;
Dogan, Serkan ;
Gursoy, Sebnem ;
Zararsiz, Gokmen ;
Yurci, Alper ;
Ozbakir, Omer ;
Guven, Kadri ;
Yucesoy, Mehmet .
WORLD JOURNAL OF HEPATOLOGY, 2013, 5 (08) :439-444
[4]   RDW to Platelet Ratio: A Novel Noninvasive Index for Predicting Hepatic Fibrosis and Cirrhosis in Chronic Hepatitis B [J].
Chen, Baode ;
Ye, Bo ;
Zhang, Jian ;
Ying, Lixiong ;
Chen, Yu .
PLOS ONE, 2013, 8 (07)
[5]   Performance of Transient Elastography for the Staging of Liver Fibrosis in Patients with Chronic Hepatitis B: A Meta-Analysis [J].
Chon, Young Eun ;
Choi, Eun Hee ;
Song, Ki Jun ;
Park, Jun Yong ;
Kim, Do Young ;
Han, Kwang-Hyub ;
Chon, Chae Yoon ;
Ahn, Sang Hoon ;
Kim, Seung Up .
PLOS ONE, 2012, 7 (09)
[6]   Assessment of Liver Fibrosis With Elastography Point Quantification vs Other Noninvasive Methods [J].
Conti, Fabio ;
Serra, Carla ;
Vukotic, Ranka ;
Felicani, Cristina ;
Mazzotta, Elena ;
Gitto, Stefano ;
Vitale, Giovanni ;
D'Errico, Antonietta ;
Andreone, Pietro .
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2019, 17 (03) :510-+
[7]   Are non-invasive fibrosis markers for chronic hepatitis B reliable in sub-Saharan Africa? [J].
Desalegn, Hailemichael ;
Aberra, Hanna ;
Berhe, Nega ;
Gundersen, Svein G. ;
Johannessen, Asgeir .
LIVER INTERNATIONAL, 2017, 37 (10) :1461-1467
[8]   Validation and comparison of seventeen noninvasive models for evaluating liver fibrosis in Chinese hepatitis B patients [J].
Dong, Minhui ;
Wu, Jingwen ;
Yu, Xueping ;
Li, Jing ;
Yang, Sisi ;
Qi, Xun ;
Mao, Richeng ;
Zhang, Yongmei ;
Yu, Jie ;
Zhu, Haoxiang ;
Yang, Feifei ;
Qin, Yanli ;
Zhang, Jiming .
LIVER INTERNATIONAL, 2018, 38 (09) :1562-1570
[9]   Evaluation and comparison of thirty noninvasive models for diagnosing liver fibrosis in chinese hepatitis B patients [J].
Dong, Xiao-Qin ;
Wu, Zhao ;
Zhao, Hong ;
Wang, Gui-Qiang .
JOURNAL OF VIRAL HEPATITIS, 2019, 26 (02) :297-307
[10]   EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection [J].
Lampertico P. ;
Agarwal K. ;
Berg T. ;
Buti M. ;
Janssen H.L.A. ;
Papatheodoridis G. ;
Zoulim F. ;
Tacke F. .
JOURNAL OF HEPATOLOGY, 2017, 67 (02) :370-398