title: Non-invasive index for predicting significant liver fibrosis: comparison of diagnostic performances in patients with chronic hepatitis B and C.
abstract: OBJECTIVE
  The majority of non-invasive markers of liver fibrosis have been developed in patients with chronic hepatitis C. We aimed to develop a formula for predicting significant fibrosis in patients with chronic viral hepatitis and to compare the usefulness of published models derived from the data obtained from patients with chronic hepatitis C.
  
  
  METHODS
  Serum markers and the METAVIR stage of fibrosis in liver biopsy specimens were compared prospectively in patients with chronic hepatitis B and C (estimation set, 367; validation set, 159).
  
  
  RESULTS
  In the estimation set, multiple forward stepwise logistic regression analysis identified γ-glutamyl transpeptidase, haptoglobin, α2-macroglobulin, matrix metalloproteinase-2, and tissue inhibitor of metalloproteinase-1 as independent predictors of significant fibrosis. A formula termed the SF index was constructed with the aforementioned five variables. The areas under the receiver operating characteristic curves of the SF index for predicting significant fibrosis were 0.828, 0.776, and 0.827 in the estimation, validation, and total sets, respectively. Using cut-off scores of 2.2 and 3.3, significant fibrosis was predicted with considerable accuracy. The diagnostic performances of the SF index and the Zeng index derived from chronic hepatitis B patients were much better than indices derived from chronic hepatitis C patients, such as the APRI, Forns index, and FIB-4.
  
  
  CONCLUSIONS
  We developed a novel formula for predicting significant fibrosis in patients with chronic viral hepatitis. Serum indices from studies in patients with chronic hepatitis C were less accurate in patients with chronic hepatitis B for predicting significant fibrosis.
authors.affiliation: Department of Gastroenterology, Ajou University School of Medicine, Youngtong-ku, Suwon, South Korea.
authors.forename: Jae Youn
authors.initials: JY
authors.lastname: Cheong
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Um
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
authors.forename: Seong Gyu
authors.initials: SG
authors.lastname: Hwang
authors.forename: Youn Jae
authors.initials: YJ
authors.lastname: Lee
authors.forename: Mong
authors.initials: M
authors.lastname: Cho
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Yang
authors.forename: Young Bae
authors.initials: YB
authors.lastname: Kim
authors.forename: Young Nyun
authors.initials: YN
authors.lastname: Park
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Cho
mesh_terms: D000328:Adult; D015415:Biomarkers; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests
chemical_list: D015415:Biomarkers