title: Fibrosis score consisting of four serum markers successfully predicts pathological fibrotic stages of chronic hepatitis B.
abstract: OBJECTIVE
  In order to evaluate and judge a fibrotic stage of patients with chronic hepatitis B, multivariate regression analysis was performed using multiple fibrosis markers.
  
  
  METHODS
  A total of 227 patients from seven hepatology units and institutes were diagnosed by needle biopsy as having chronic liver disease caused by hepatitis B virus. Twenty-three variables and their natural logarithmic transformation were employed in the multivariate analysis. Multiple regression function was generated from data of 158 patients in one hospital, and validation was performed using the other data of 69 patients from six other hospitals.
  
  
  RESULTS
  After stepwise variable selection, multivariate regression analysis finally obtained the following function: z = 1.40 × ln (type IV collagen 7S) (ng/mL) - 0.017 × (platelet count) (×1000(3) /mm(3) ) + 1.24 × ln (tissue inhibitor of matrix metalloproteinase-2) (ng/mL) + 1.19 × ln (α-2-macroglobulin) (mg/dL) - 9.15. Median values of fibrosis scores of F1 (n = 73), F2 (n = 42), F3 (n = 31) and F4 stages (n = 12) were calculated as 0.95, 2.07, 2.98 and 3.63, respectively. Multiple regression coefficient and coefficient of determination were 0.646 and 0.418, respectively. Validation with patient data from other institutions demonstrated good reproducibility of fibrosis score for hepatitis B (FSB), showing 1.33 in F1 (n = 27), 2.20 in F2 (n = 20), 3.11 in F3 (n = 20) and 5.30 in F4 (n = 2), respectively.
  
  
  CONCLUSIONS
  A concise multiple regression function using four laboratory parameters successfully predicted pathological fibrosis stage of patients with hepatitis B virus infection.
authors.affiliation: Department of Hepatology, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ikeda
authors.forename: Namiki
authors.initials: N
authors.lastname: Izumi
authors.forename: Eiji
authors.initials: E
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yotsuyanagi
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Junichi
authors.initials: J
authors.lastname: Fukushima
authors.forename: Fukuo
authors.initials: F
authors.lastname: Kondo
authors.forename: Toshio
authors.initials: T
authors.lastname: Fukusato
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.forename: Norio
authors.initials: N
authors.lastname: Hayashi
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kumada