Simpler score of routine laboratory tests predicts liver fibrosis in patients with chronic hepatitis B.
OBJECTIVE
In recent years, a great interest has been dedicated to the development of noninvasive predictive models to substitute liver biopsy for fibrosis assessment and follow-up. Our aim was to provide a simpler model consisting of routine laboratory markers for predicting liver fibrosis in patients chronically infected with hepatitis B virus (HBV) in order to optimize their clinical management.


METHODS
Liver fibrosis was staged in 386 chronic HBV carriers who underwent liver biopsy and routine laboratory testing. Correlations between routine laboratory markers and fibrosis stage were statistically assessed. After logistic regression analysis, a novel predictive model was constructed. This S index was validated in an independent cohort of 146 chronic HBV carriers in comparison to the SLFG model, Fibrometer, Hepascore, Hui model, Forns score and APRI using receiver operating characteristic (ROC) curves.


RESULTS
The diagnostic values of each marker panels were better than single routine laboratory markers. The S index consisting of gamma-glutamyltransferase (GGT), platelets (PLT) and albumin (ALB) (S-index: 1000 x GGT/(PLT x ALB(2))) had a higher diagnostic accuracy in predicting degree of fibrosis than any other mathematical model tested. The areas under the ROC curves (AUROC) were 0.812 and 0.890 for predicting significant fibrosis and cirrhosis in the validation cohort, respectively.


CONCLUSIONS
The S index, a simpler mathematical model consisting of routine laboratory markers predicts significant fibrosis and cirrhosis in patients with chronic HBV infection with a high degree of accuracy, potentially decreasing the need for liver biopsy.
Zhou
Kun
K
Department of Gastroenterology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Gao
Chun-Fang
CF
Zhao
Yun-Peng
YP
Liu
Hai-Lin
HL
Zheng
Rui-Dan
RD
Xian
Jian-Chun
JC
Xu
Hong-Tao
HT
Mao
Yi-Min
YM
Zeng
Min-De
MD
Lu
Lun-Gen
LG
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016009:Chi-Square Distribution; D002681:China; D005260:Female; D006305:Health Status Indicators; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000201:enzymology* / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D016015:Logistic Models; D008297:Male; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000032:analysis*; D012720:Severity of Illness Index; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood*
D015415:Biomarkers; D012709:Serum Albumin; D005723:gamma-Glutamyltransferase