title: The diagnostic value of a globulin/platelet model for evaluating liver fibrosis in chronic hepatitis B patients.
abstract: BACKGROUND
  Liver biopsy, which is considered the best method for evaluating hepatic fibrosis, has important adverse events. Therefore, non-invasive tests have been developed to determine the degree of hepatic fibrosis in patients with chronic hepatitis B.
  
  
  OBJECTIVE
  To verify the usefulness of a new fibrosis index the globulin/platelet model in patients with chronic hepatitis B and to compare it with other noninvasive tests for predicting significant fibrosis. This study was the second to evaluate the globulin/platelet model in HBV patients.
  
  
  METHODS
  We retrospectively investigated 228 patients with chronic hepatitis B who performed liver biopsy from 2013 to 2014. The globulin/platelet model, APGA [AST/Platelet/Gamma-glutamyl transpeptidase/Alfa-fetoprotein], FIB4, fibrosis index, cirrhosis discriminate score, and Fibro-quotient were calculated, and the diagnostic accuracies of all of the fibrosis indices were compared between the F0-2 (no-mild fibrosis) and F3-6 (significant fibrosis) groups.
  
  
  RESULTS
  All of the noninvasive markers were significantly correlated with the stage of liver fibrosis (p < 0,001). To predict significant fibrosis (F ≥ 3), the area under the curve (95% CI) was found to be greatest for APGA (0.83 [0.74-0.86]), followed by FIB-4 (0.75[0.69-0.80]), the globulin/platelet model (0.74 [0.68-0.79]), fibrosis index (0.72 [0.6-0.78], cirrhosis discriminate score (0.71 [0.64-0.76]) and Fibro-quotient (0.62 [0.55-0.7]). The area under the receiver operating characteristic curves of APGA was significantly higher than that of the other noninvasive fibrosis markers (p < 0.05).
  
  
  CONCLUSIONS
  While the APGA index was found to be the most valuable test for the prediction significant fibrosis in patients with chronic hepatitis B, GP model was the thirth valuable test. Therefore, we recommended that APGA could be used instead of the GP model for prediction liver fibrosis.
authors.affiliation: Gastroenterology, Kayserı Training and Research Hospital, Turkey.
authors.forename: Banu Demet
authors.initials: BD
authors.lastname: Coskun
authors.affiliation: Gastroenterology, Kayseri Training and Research hospital, Turkey.
authors.forename: Engin
authors.initials: E
authors.lastname: Altinkaya
authors.affiliation: Pediatric Gastroenterology, Kayseri Trainig and Research hospital, Turkey.
authors.forename: Eylem
authors.initials: E
authors.lastname: Sevinc
authors.affiliation: İnternal Medicine, Kayseri Training and Research Hospital, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozen
authors.affiliation: Pathology, Kayseri Trainig and Research hospital, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Karaman
authors.affiliation: Kayseri Training and Research Hospital. Kayseri, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karaman
authors.affiliation: Gastroenterology, Kayseri Training and Research Hospital, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Poyrazoglu
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D003661:Decision Support Techniques; D005916:Globulins; D006305:Health Status Indicators; D019694:Hepatitis B, Chronic / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D008875:Middle Aged; D010976:Platelet Count; D012372:ROC Curve; D012189:Retrospective Studies; D012712:Serum Globulins / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D005916:Globulins; D012712:Serum Globulins