Noninvasive models to predict liver cirrhosis in patients with chronic hepatitis B.
OBJECTIVE
Few noninvasive models of chronic hepatitis B (CHB) to predict liver cirrhosis have been studied. The aim of the current study is to investigate the diagnostic accuracy of two simple novel models of spleen-platelet ratio index (SPRI) and age-spleen-platelet ratio index (ASPRI) in patients with CHB.


METHODS
A total of 346 consecutive treatment-naïve patients with CHB were retrospectively studied. The aspartate to alanine aminotransferase ratio (AAR), age-platelet index (API), aspartate aminotransferase to platelet ratio index (APRI), SPRI, and ASPRI were compared with liver histology.


RESULTS
AAR, APRI, SPRI, API, and ASPRI correlated significantly to fibrosis stage (all P<0.001). The diagnostic accuracy of ASPRI was the highest among five tests for prediction of cirrhosis (area under receiver operating characteristic curve, AUROC=0.893). Using a cutoff score of ASPRI>12, the presence of cirrhosis could be correctly identified with a high accuracy (96.3% positive predictive value) in 35 (10.1%) of 346 patients. Similarly, using a cutoff of <5, the presence of cirrhosis could be totally excluded with 100% of negative predictive value in 120 (34.7%) of 346 patients.


CONCLUSIONS
ASPRI was accurate in predicting cirrhosis and screening with ASPRI has the potential to reduce the number of liver biopsies in CHB patients.
Kim
Beom Kyung
BK
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Kim
Sung Ae
SA
Park
Young Nyun
YN
Cheong
Jae Youn
JY
Kim
Hwa Sook
HS
Park
Jun Yong
JY
Cho
Sung Won
SW
Han
Kwang-Hyub
KH
Chon
Chae Yoon
CY
Moon
Young Myoung
YM
Ahn
Sang Hoon
SH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D001706:Biopsy; D004796:Clinical Enzyme Tests; D018450:Disease Progression; D005260:Female; D019694:Hepatitis B, Chronic / Q000097:blood / Q000150:complications* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013154:Spleen / Q000473:pathology*
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase