The relationship between liver histology and noninvasive markers in primary biliary cirrhosis.
BACKGROUND
Primary biliary cirrhosis (PBC) is a disease that affects liver with various severity and progression rates. It is important to diagnose advanced stage of the disease to lower liver-related morbidity and mortality. Since liver biopsy is an invasive method, liver biopsy tends to be replaced by noninvasive methods. In this study, we aim to show the role of aminotransferase to platelet ratio index (APRI) and fibrosis index on the basis of the four factors (FIB-4) scores, laboratory values, and their effectiveness in predicting advanced disease.


METHODS
PBC patients diagnosed pathologically at Numune Education and Research Hospital were included in the study between the years 1995 and 2013. Patients were grouped according to their fibrosis level: group 1 (early stage) included 18 patients with F1 and F2 fibrosis and group 2 (advanced stage) included 22 patients with F3 and F4 fibrosis. APRI and FIB-4 scores, routine laboratory values, and their proportions were compared. The effectiveness of parameters showing advanced stage was further compared.


RESULTS
There were statistically significant differences in APRI, FIB-4 scores, and aspartate aminotransferase (AST) levels between the groups with early and advanced stages of disease. Receiver operating curve analysis was used to determine APRI, FIB-4 and AST levels. The most effective parameters for diagnosing an advanced stage were APRI, AST levels, and FIB-4 scores, respectively.


CONCLUSIONS
In conclusion, APRI and FIB-4 scores can be calculated simply and easily by routine laboratory tests at low cost and also these scores may be a predictor of advanced stage of the disease in PBC. These tests may be reproducible and may be used to monitor disease progression.
aAdana Numune Training and Research Hospital, Department of Gastroenterology, Adana bUmraniye Education and Resarch Hospital, Department of Gastroenterology, Istanbul cKoru Hospital, Department of Gastroenterology dTurkiye Yuksek Ihtisas Training and Research Hospital, Department of Gastroenterology eAnkara Numune Training and Research Hospital, Department of Gastroenterology, Ankara, Turkey.
Sehmus
S
Olmez
Suleyman
S
Sayar
Ufuk
U
Avcioglu
İlyas
İ
Tenlik
Ersan
E
Ozaslan
Hasan T
HT
Koseoglu
Emin
E
Altiparmak
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D001706:Biopsy; D004796:Clinical Enzyme Tests / Q000379:methods; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged; D010976:Platelet Count; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase