Abstract
BACKGROUND
Liver biopsy is the gold standard for determining the degree of fibrosis in patients with chronic hepatitis B, but it has certain limitations in clinical application because of its invasive nature. Hence, non-invasive assessment is essential.
AIM
To compare the diagnostic value of ten noninvasive models indexes for liver fibrosis in patients with chronic hepatitis B.
METHODS
A total of 1030 patients with chronic hepatitis B admitted during June 2003 and August 2019 were enrolled in the study. All the patients received liver biopsy and blood and ultrasound examinations. The AST-to-ALT ratio, AST-to-platelet ratio index, age platelet index, cirrhosis discriminant score, fibrosis index based on four factors, gamma-glutamyltranspeptidase-to-platelet ratio, S-index, spleen-to-platelet ratio index, age-spleen-to-platelet ratio index (ASPRI), and FV (our model) were calculated. Area under the receiver operating characteristic curve (AUROC) was used to assess the clinical value of noninvasive models in diagnosis of liver fibrosis.
RESULTS
All the models were correlated with the stage of liver fibrosis (r = 0.215, 0.382, 0.629, 0.449, 0.612, 0.618, 0.654, 0.658, 0.707, and 0.775, respectively; P < 0.05). The best AUROCs of FV and ASPRI for diagnosis of significant liver fibrosis (F2-3) were 0.834 and 0.796, with sensitivities of 78.8% and 70.2%, specificities of 74.0% and 76.1%, and accuracies of 76.3% and 73.3%, respectively. The best AUROCs for diagnosis of early liver cirrhosis (F4) were 0.928 and 0.912, with sensitivities of 85.4% and 89.4%, specificities of 85.0% and 77.3%, accuracies of 85.1% and 79.7%, negative predictive values of 96.2% and 96.5%, and negative likelihood ratios of 0.172 and 0.137, respectively.
CONCLUSION
FV and ASPRI have better accuracies than other noninvasive diagnostic indexes in diagnosing significant liver fibrosis in patients with chronic hepatitis B, especially in the diagnosis of early liver cirrhosis.
Collapse