Chih-Lin Lin1, Chen-Hua Liu, Chia-Chi Wang, Cheng-Chao Liang, Tung-Hung Su, Chun-Jen Liu, Jia-Horng Kao. 1. *Department of Gastroenterology, Taipei City Hospital, Ren-Ai branch †Department of Psychology, National Chengchi University ‡Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine §Department of Internal Medicine, Division of Gastroenterology and Hepatology ∥Hepatitis Research Center **Department of Medical Research, National Taiwan University Hospital #Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei ¶Department of Hepatology, Buddhist Tzu Chi General Hospital, Taipei Branch and School of Medicine, Tzu Chi University, Hualien, Taiwan.
Abstract
GOALS/ BACKGROUND:Aspartate aminotransferase to platelet ratio index (APRI) and FIB-4 index are noninvasive biomarkers to evaluate hepatic fibrosis. However, their usefulness in chronic hepatitis B (CHB) patients remains unclear. METHODS: A total of 631 CHB patients were enrolled and randomly divided into a training set (n=420) and a validation set (n=211). Areas under receiver operating characteristic (AUROC) curves for FIB-4 index and APRI were compared to evaluate their diagnostic values in identifying significant fibrosis and cirrhosis. RESULTS: The AUROC of FIB-4 index for the diagnosis of significant fibrosis and cirrhosis in the entire cohort was higher than that of APRI (0.769 vs. 0.704, P=0.0003 and 0.869 vs. 0.706, P<0.0001). By using cutoff APRI of 0.38 and 4.04 in the validation set, the diagnostic accuracy for absence of significant fibrosis and presence of cirrhosis was 67.7% and 76.8%. At cutoff FIB-4 index of 0.87 and 3.40 in the validation set, the diagnostic accuracy for absence of significant fibrosis and presence of cirrhosis was 69.2% and 84.4%. Compared with patients with concordance, patients with overestimated score by FIB-4 index had a significantly higher serum alanine aminotransferase (ALT) level (299±245 vs. 168±196 U/L, P=0.001) as well as a higher ratio of hepatitis flare (ALT>400 U/L) (25% vs. 7.9%, P=0.008). CONCLUSIONS: FIB-4 index proves to be more reliable than APRI in predicting significant fibrosis and cirrhosis in CHB patients. By using FIB-4 index, a substantial proportion of patients could be identified correctly as significant fibrosis and cirrhosis without further invasive liver biopsy.
RCT Entities:
GOALS/ BACKGROUND: Aspartate aminotransferase to platelet ratio index (APRI) and FIB-4 index are noninvasive biomarkers to evaluate hepatic fibrosis. However, their usefulness in chronic hepatitis B (CHB) patients remains unclear. METHODS: A total of 631 CHB patients were enrolled and randomly divided into a training set (n=420) and a validation set (n=211). Areas under receiver operating characteristic (AUROC) curves for FIB-4 index and APRI were compared to evaluate their diagnostic values in identifying significant fibrosis and cirrhosis. RESULTS: The AUROC of FIB-4 index for the diagnosis of significant fibrosis and cirrhosis in the entire cohort was higher than that of APRI (0.769 vs. 0.704, P=0.0003 and 0.869 vs. 0.706, P<0.0001). By using cutoff APRI of 0.38 and 4.04 in the validation set, the diagnostic accuracy for absence of significant fibrosis and presence of cirrhosis was 67.7% and 76.8%. At cutoff FIB-4 index of 0.87 and 3.40 in the validation set, the diagnostic accuracy for absence of significant fibrosis and presence of cirrhosis was 69.2% and 84.4%. Compared with patients with concordance, patients with overestimated score by FIB-4 index had a significantly higher serum alanine aminotransferase (ALT) level (299±245 vs. 168±196 U/L, P=0.001) as well as a higher ratio of hepatitis flare (ALT>400 U/L) (25% vs. 7.9%, P=0.008). CONCLUSIONS: FIB-4 index proves to be more reliable than APRI in predicting significant fibrosis and cirrhosis in CHB patients. By using FIB-4 index, a substantial proportion of patients could be identified correctly as significant fibrosis and cirrhosis without further invasive liver biopsy.
Authors: Rong-Qi Wang; Qing-Shan Zhang; Su-Xian Zhao; Xue-Min Niu; Jing-Hua Du; Hui-Juan Du; Yue-Min Nan Journal: J Int Med Res Date: 2016-11-11 Impact factor: 1.671
Authors: Hyung Joon Yim; Won Kim; Sang Hoon Ahn; Jin Mo Yang; Jae Young Jang; Yong Oh Kweon; Yong Kyun Cho; Yoon Jun Kim; Gun Young Hong; Dong Joon Kim; Young Kul Jung; Soon Ho Um; Joo Hyun Sohn; Jin Woo Lee; Sung Jae Park; Byung Seok Lee; Ju Hyun Kim; Hong Soo Kim; Seung Kew Yoon; Moon Young Kim; Kwan Sik Lee; Young Suk Lim; Wan Sik Lee; Kwang-Hyub Han Journal: Am J Gastroenterol Date: 2020-08 Impact factor: 12.045