Novel index for the prediction of significant liver fibrosis and cirrhosis in chronic hepatitis B patients in China

• Published in: World journal of gastroenterology : WJG 2022-07, Vol.28 (27), p.3503-3513
• Main Authors: Liao, Min-Jun, Li, Jun, Dang, Wei, Chen, Dong-Bo, Qin, Wan-Ying, Chen, Pu, Zhao, Bi-Geng, Ren, Li-Ying, Xu, Ting-Feng, Chen, Hong-Song, Liao, Wei-Jia
• Format: Article
• Language: English
• Subjects: Retrospective Study
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v28.i27.3503

BACKGROUNDNoninvasive, practical, and convenient means of detection for the prediction of liver fibrosis and cirrhosis in China are greatly needed. AIMTo develop a precise noninvasive test to stage liver fibrosis and cirrhosis. METHODSWith liver biopsy as the gold standard, we established a new index, [alkaline phosphatase (U/L) + gamma-glutamyl transpeptidase (U/L)/platelet (109/L) (AGPR)], to predict liver fibrosis and cirrhosis. In addition, we compared the area under the receiver operating characteristic curve (AUROC) of AGPR, gamma-glutamyl transpeptidase to platelet ratio, aspartate transaminase to platelet ratio index, and FIB-4 and evaluated the accuracy of these routine laboratory indices in predicting liver fibrosis and cirrhosis. RESULTSCorrelation analysis revealed a significant positive correlation between AGPR and liver fibrosis stage (P < 0.001). In the training cohort, the AUROC of AGPR was 0.83 (95%CI: 0.78-0.87) for predicting fibrosis (≥ F2), 0.84 (95%CI: 0.79-0.88) for predicting extensive fibrosis (≥ F3), and 0.87 (95%CI: 0.83-0.91) for predicting cirrhosis (F4). In the validation cohort, the AUROCs of AGPR to predict ≥ F2, ≥ F3 and F4 were 0.83 (95%CI: 0.77-0.88), 0.83 (95%CI: 0.77-0.89), and 0.84 (95%CI: 0.78-0.89), respectively. CONCLUSIONThe AGPR index should become a new, simple, accurate, and noninvasive marker to predict liver fibrosis and cirrhosis in chronic hepatitis B patients.