Staging of liver fibrosis in chronic hepatitis B patients with a composite predictive model: a comparative study.
OBJECTIVE
To evaluate the efficacy of 6 noninvasive liver fibrosis models and to identify the most valuable model for the prediction of liver fibrosis stage in chronic hepatitis B (CHB) patients.


METHODS
Seventy-eight CHB patients were consecutively enrolled in this study. Liver biopsy was performed and blood serum was obtained at admission. Histological diagnosis was made according to the METAVIR system. Significant fibrosis was defined as stage score > or = 2, severe fibrosis as stage score > or = 3. The diagnostic accuracy of 6 noninvasive liver fibrosis models, including serum aspartate aminotransferase (AST) to platelet ratio index (APRI), FIB-4, Forn's index, Fibrometer, Hepascore, and Shanghai Liver Fibrosis Group's index (SLFG), was investigated.


RESULTS
The APRI, FIB-4 and Forn's index under receiver operating characteristic curve (AUROC) for significant fibrosis were 0.71, 0.75 and 0.79, respectively, with a diagnosis accuracy of 67%, 77% and 80%, respectively, and 0.80, 0.87 and 0.86, respectively, under the AUROC for severe fibrosis. The Hepascore, SLFG, and Fibrometer were 0.80, 0.83 and 0.85, respectively under the AUROC for significant fibrosis (P < 0.01). The diagnosis accuracy of Hepascore and SLFG was 86% and 88%, respectively. The Hepascore, SLFG, and Fibrometer were 0.95, 0.93, and 0.94, respectively, under the AUROC for severe fibrosis (P < 0.01).


CONCLUSIONS
The models containing direct serum markers have a better diagnostic value than those not containing direct serum markers.
Wu
Sheng-Di
SD
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Wang
Ji-Yao
JY
Li
Lei
L
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D055815:Young Adult
D015415:Biomarkers