Routine indexes for cirrhosis and significant fibrosis detection in patients with compensated chronic hepatitis B.
Adult
Area Under Curve
Aspartate Aminotransferases
/ blood
Biomarkers
/ blood
Biopsy, Fine-Needle
Case-Control Studies
Erythrocyte Indices
Female
Fibrosis
Hepatitis B Surface Antigens
/ blood
Hepatitis B, Chronic
/ blood
Humans
Liver Cirrhosis
/ blood
Male
Middle Aged
Platelet Count
Predictive Value of Tests
Retrospective Studies
Severity of Illness Index
Chronic hepatitis B
Cirrhosis
Routine index
Significant fibrosis
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
12
11
2017
revised:
20
05
2018
accepted:
01
07
2018
pubmed:
5
8
2018
medline:
14
6
2019
entrez:
5
8
2018
Statut:
ppublish
Résumé
Fibrosis index based on the four factors (FIB-4) and aspartate aminotransferase to platelet ratio index (APRI) were not well validated in patients with chronic hepatitis B (CHB). The aim of this study was to validate the performances of these indexes and construct novel indexes for liver fibrosis assessment. A total of 1438 consecutive antivirus treatment-naïve patients with CHB were analysed, and two novel indexes (named HeBCI and HeBFI) were derived for cirrhosis and significant fibrosis detection. For cirrhosis, the area under receiver operating characteristic curves (AUROCs) were 0.841 for HeBCI, 0.708 for FIB-4 and 0.623 for APRI in the model set, and 0.779, 0.690, 0.595 in the validation set. For significant fibrosis, the AUROCs were 0.781 for HeBFI, 0.693 for APRI and 0.641 for FIB-4 in the model set, and 0.776, 0.729, 0.641 in the validation set. HeBCI determined 750 (52.2%) patients as having cirrhosis or non-cirrhosis with an accuracy of 86%. HeBFI detected 673 (46.8%) patients with or without significant fibrosis with an accuracy of 76.6%. As economical and convenient indexes, HeBCI and HeBFI are suitable to serve as outpatient tools for detecting significant fibrosis and cirrhosis to reduce the need of liver biopsy significantly in resource-limited settings.
Sections du résumé
BACKGROUND AND AIM
Fibrosis index based on the four factors (FIB-4) and aspartate aminotransferase to platelet ratio index (APRI) were not well validated in patients with chronic hepatitis B (CHB). The aim of this study was to validate the performances of these indexes and construct novel indexes for liver fibrosis assessment.
METHODS
A total of 1438 consecutive antivirus treatment-naïve patients with CHB were analysed, and two novel indexes (named HeBCI and HeBFI) were derived for cirrhosis and significant fibrosis detection.
RESULTS
For cirrhosis, the area under receiver operating characteristic curves (AUROCs) were 0.841 for HeBCI, 0.708 for FIB-4 and 0.623 for APRI in the model set, and 0.779, 0.690, 0.595 in the validation set. For significant fibrosis, the AUROCs were 0.781 for HeBFI, 0.693 for APRI and 0.641 for FIB-4 in the model set, and 0.776, 0.729, 0.641 in the validation set. HeBCI determined 750 (52.2%) patients as having cirrhosis or non-cirrhosis with an accuracy of 86%. HeBFI detected 673 (46.8%) patients with or without significant fibrosis with an accuracy of 76.6%.
CONCLUSIONS
As economical and convenient indexes, HeBCI and HeBFI are suitable to serve as outpatient tools for detecting significant fibrosis and cirrhosis to reduce the need of liver biopsy significantly in resource-limited settings.
Identifiants
pubmed: 30076017
pii: S1590-8658(18)30811-9
doi: 10.1016/j.dld.2018.07.001
pii:
doi:
Substances chimiques
Biomarkers
0
Hepatitis B Surface Antigens
0
Aspartate Aminotransferases
EC 2.6.1.1
Types de publication
Journal Article
Validation Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
127-134Informations de copyright
Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.