title: A proposed predictive model for advanced fibrosis in patients with chronic hepatitis B and its validation.
abstract: We created a predictive model using serum-based biomarkers for advanced fibrosis (F3 or more) in patients with chronic hepatitis B (CHB) and to confirm the accuracy in an independent cohort.A total of 249 CHB patients were analyzed. To achieve our study aim, a training group (n = 125) and a validation group (n = 124) were formed. In the training group, parameters related to the presence of advanced fibrosis in univariate and multivariate analyses were examined, and a formula for advanced fibrosis was created. Next, we verified the applicability of the predictive model in the validation group.Multivariate analysis identified that gamma-glutamyl transpeptidase (GGT, P = 0.0343) and platelet count (P = 0.0034) were significant predictors of the presence of advanced fibrosis, while Wisteria floribunda agglutinin-positive Mac-2-binding protein (WFA-M2BP, P = 0.0741) and hyaluronic acid (P = 0.0916) tended to be significant factors. Using these 4 parameters, we created the following formula: GMPH score = -0.755 - (0.015 × GGT) - (0.268 × WFA-M2BP) + (0.167 × platelet count) + (0.003 × hyaluronic acid). In 8 analyzed variables (WFA-M2BP, aspartate aminotransferase-to-platelet ratio index, FIB-4 index, prothrombin time, platelet count, hyaluronic acid, Forns index, and GMPH score), GMPH score had the highest area under the receiver operating characteristic (AUROC) curve for advanced fibrosis with a value of 0.8064 in the training group and in the validation group, GMPH score also had the highest AUROC (0.7782). In all subgroup analyses of the hepatitis B virus (HBV) status (HB surface antigen quantification, HBV-DNA quantification, and HBe antigen seropositivity), GMPH score in F3 or F4 was significantly lower than that in F0 to F2. In the above mentioned 8 variables, differences between the liver fibrosis stages (F0 to F1 vs F2, F2 vs F3, F3 vs F4, F0 to F1 vs F3, F0 to F1 vs F4, and F2 vs F4) for the entire cohort (n = 249) were all significant only in GMPH score.In conclusion, the GMPH scoring system may be helpful for detecting advanced liver fibrosis in patients with CHB.
authors: Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors: Hiroki
authors: H
authors: Nishikawa
authors: Kunihiro
authors: K
authors: Hasegawa
authors: Akio
authors: A
authors: Ishii
authors: Ryo
authors: R
authors: Takata
authors: Hirayuki
authors: H
authors: Enomoto
authors: Kazunori
authors: K
authors: Yoh
authors: Kyohei
authors: K
authors: Kishino
authors: Yoshihiro
authors: Y
authors: Shimono
authors: Yoshinori
authors: Y
authors: Iwata
authors: Chikage
authors: C
authors: Nakano
authors: Takashi
authors: T
authors: Nishimura
authors: Nobuhiro
authors: N
authors: Aizawa
authors: Yoshiyuki
authors: Y
authors: Sakai
authors: Naoto
authors: N
authors: Ikeda
authors: Tomoyuki
authors: T
authors: Takashima
authors: Hiroko
authors: H
authors: Iijima
authors: Shuhei
authors: S
authors: Nishiguchi
mesh_terms: D000951:Antigens, Neoplasm / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000097:blood / Q000473:pathology*; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood; D008875:Middle Aged; D015233:Models, Statistical; D037121:Plant Lectins / Q000097:blood; D010976:Platelet Count; D034781:Receptors, N-Acetylglucosamine / Q000097:blood; D015203:Reproducibility of Results; D012189:Retrospective Studies; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D000951:Antigens, Neoplasm; D015415:Biomarkers; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D008562:Membrane Glycoproteins; D037121:Plant Lectins; D034781:Receptors, N-Acetylglucosamine; C114782:TAA90K protein, human; C040129:wisteria lectin; D006820:Hyaluronic Acid; D005723:gamma-Glutamyltransferase