G Ozyalvacli1, A Kucukbayrak2, M Kurt3, K Gurel4, O Gunes2, C Ustun2, H Akdeniz2. 1. Departments of Pathology, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey. 2. Departments of Infectious Diseases, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey. 3. Departments of Gastroenterology, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey. 4. Departments of Radiology, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey.
Abstract
BACKGROUND: The gold standarda method used for assessing necroinflammatory activity and fibrosis in the liver is a liver biopsy which has many disadvantages. Therefore, many investigators have been trying to develop non-invasive tests for predicting liver fibrosis score (LFS) of these patients. The aim of this study is to describe the relationship between certain non-invasive fibrosis markers with LFS and histological activity index (HAI) detected histopathologically by liver biopsy in chronic hepatitis B patients. MATERIALS AND METHODS: A total of 54 patients who had undergone a liver biopsy with the diagnosis of chronic HBV infection were included in the study. Ishak scoring was used for the evaluation of liver fibrosis, and a modified Knodell HAI was used for demonstration of necroinflammation. In this study, non-invasive fibrosis tests were calculated as described in previous studies. RESULTS: Histological acitivity index was positively correlated with age, age/platelet index, cirrhosis discriminant score (CDS), AST/platelet ratio index (APRI), AST/platelet/GGT/AFP index (APGA), fibro-quotient (Fibro-Q), Goteburg University Cirrhosis Index (Guci), and Platelet/Age/Phosphatase/AFP/AST index (PAPAS). When divided into two groups according to HAI, Guci and APGA were found significantly different both in >4 and >4 HAI groups than the other group. In ROC analysis performed for LFS; PAPAS, APGA, FFI and APRI were the markers having the highest AUC levels, and in ROC analysis performed for HAI; Guci, APRI and APGA were the markers with the highest AUC levels. CONCLUSIONS: APRI, APGA and GUCI tests may be helpful in prediction of necroinflammatory scores in the liver.
BACKGROUND: The gold standarda method used for assessing necroinflammatory activity and fibrosis in the liver is a liver biopsy which has many disadvantages. Therefore, many investigators have been trying to develop non-invasive tests for predicting liver fibrosis score (LFS) of these patients. The aim of this study is to describe the relationship between certain non-invasive fibrosis markers with LFS and histological activity index (HAI) detected histopathologically by liver biopsy in chronic hepatitis Bpatients. MATERIALS AND METHODS: A total of 54 patients who had undergone a liver biopsy with the diagnosis of chronic HBV infection were included in the study. Ishak scoring was used for the evaluation of liver fibrosis, and a modified Knodell HAI was used for demonstration of necroinflammation. In this study, non-invasive fibrosis tests were calculated as described in previous studies. RESULTS: Histological acitivity index was positively correlated with age, age/platelet index, cirrhosis discriminant score (CDS), AST/platelet ratio index (APRI), AST/platelet/GGT/AFP index (APGA), fibro-quotient (Fibro-Q), Goteburg University Cirrhosis Index (Guci), and Platelet/Age/Phosphatase/AFP/AST index (PAPAS). When divided into two groups according to HAI, Guci and APGA were found significantly different both in >4 and >4 HAI groups than the other group. In ROC analysis performed for LFS; PAPAS, APGA, FFI and APRI were the markers having the highest AUC levels, and in ROC analysis performed for HAI; Guci, APRI and APGA were the markers with the highest AUC levels. CONCLUSIONS: APRI, APGA and GUCI tests may be helpful in prediction of necroinflammatory scores in the liver.
Authors: Yu Zhijian; Li Hui; Yao Weiming; Lin Zhanzhou; Chen Zhong; Zheng Jinxin; Wang Hongyan; Deng Xiangbin; Yang Weizhi; Li Duoyun; Liu Xiaojun; Deng Qiwen Journal: Gastroenterol Res Pract Date: 2015-07-05 Impact factor: 2.260