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Vol. 42. Issue 5.
Pages 281-288 (May 2019)
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Vol. 42. Issue 5.
Pages 281-288 (May 2019)
Original article
DOI: 10.1016/j.gastre.2018.12.001
Comparison of non-invasive models for predicting liver damage in chronic hepatitis B patients
Comparación de modelos no invasivos para pronosticar el daño hepático en pacientes con hepatitis B crónica
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Kangkang Yua, Zunguo Dub, Qian Lic, Qi Chenga, Chong Huanga, Guangfeng Shia, Ning Lia,
Corresponding author
lining_hs@fudan.edu.cn

Corresponding author.
a Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China
b Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China
c Department of General Surgery, Qingdao Municipal Hospital, Qingdao 266071, China
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Tables (4)
Table 1. Characteristics of patients at baseline.
Table 2. Analysis for factors associated with the presence of significant fibrosis.
Table 3. Analysis for factors associated with the presence of severe necroinflammation activity.
Table 4. Assessment of diagnostic performance of non-invasive scores for significant fibrosis and severe necroinflammation activity.
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Additional material (1)
Abstract
Introduction

Inexpensive blood tests have been well established as alternatives to liver biopsies to evaluate liver fibrosis in CHB patients. Here, we aim to compare their diagnostic accuracy in assessing liver fibrosis and necroinflammation.

Patients and methods

A retrospective study was performed to evaluate the predictive value of non-invasive models in chronic hepatitis B patients with liver fibrosis by the area under receiver operating characteristic curve (AUROC). The clinical data of 160 patients were collected from medical records.

Results

Of the 160 consecutive treatment-naïve CHB patients, 29 (16%) had significant fibrosis and 34 (21%) had severe necroinflammation. The AUROC of the gamma-glutamyl transpeptidase to platelet ratio (GPR) (0.761, 95% CI 0.671–0.850) for predicting significant fibrosis was significantly higher than that of the aspartate transaminase-to-platelet ratio index (APRI) (0.680, 95% CI 0.585–0.774, p=0.034), but comparable with the fibrosis index based on four factors (Fib-4) (0.746, 95% CI 0.656–0.836, p=0.703), while for predicting severe necroinflammation, the performance of the GPR (AUROC=0.869, 95% CI 0.800–0.937) was better than the APRI (AUROC=0.816, 95% CI 0.740–0.892, p=0.085) and Fib-4 (0.792, 95% CI 0.711–0.873, p=0.023).

Discussion

GPR is a satisfactory model to stage liver fibrosis and to grade necroinflammation activity, representing a convenient non-invasive alternative to liver biopsy in China.

Keywords:
Necroinflammation
Liver fibrosis
Noninvasive model
Resumen
Introducción

los análisis de sangre asequibles se han consolidado como alternativas a la biopsia hepática para evaluar la fibrosis hepática en pacientes con HBC. En este caso, nuestro objetivo es comparar su precisión diagnóstica en la evaluación de la fibrosis hepática y en la necroinflamación.

Pacientes y métodos

se realizó un estudio retrospectivo para evaluar el valor pronóstico de los modelos no invasivos en pacientes con hepatitis B crónica con fibrosis hepática en el área bajo la curva de rendimiento diagnóstico (AUROC). Se recopilaron los datos clínicos de 160 pacientes a partir de las historias clínicas.

Resultados

De 160 pacientes HBC que no habían recibido tratamiento consecutivo, 29 (16%) presentaron una importante fibrosis y 34 (21%), necroinflamación grave. La AUROC de la gammaglutamiltranspeptidasa respecto a la proporción de plaquetas (GPR) (0,761; IC95%: 0,671-0,850) para pronosticar una fibrosis importante fue considerablemente más alta que el índice de relación aspartato-transaminasa-plaquetas (APRI) (0,680; IC95%: 0,585-0,774; p=0,034), pero comparable con el índice de fibrosis basado en cuatro factores (Fib-4) (0,746; IC95%: 0,656-0,836; p=0,703), mientras que para el pronóstico de la necroinflamación grave, el rendimiento de GPR (AUROC=0,869; IC95%: 0,800-0,937) fue mejor que el de APRI (AUROC=0,816; IC95%: 0,740-0,892; p=0,085) y el de Fib-4 (0,792; IC95%: 0,711-0,873; p=0,023).

Discusión

el GPR es un modelo satisfactorio para clasificar la fibrosis hepática y para calificar la actividad de la necroinflamación, y representa una alternativa práctica y no invasiva a la biopsia hepática en China.

Palabras clave:
Necroinflamación
Fibrosis hepática
Modelo no invasivo

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