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. 2021 Sep;35(9):e23960.
doi: 10.1002/jcla.23960. Epub 2021 Aug 17.

Performance of noninvasive tools for identification of minimal liver fibrosis in patients with hepatitis B virus infection

Hong Zhang  1 , XinXing Shi  1 , Lin Wang  1 , Yilan Zeng  1 , Xintong Kang  1 , Liang Huang  1
Affiliations

Performance of noninvasive tools for identification of minimal liver fibrosis in patients with hepatitis B virus infection

Hong Zhang et al. J Clin Lab Anal. 2021 Sep.

Abstract

Background: Various noninvasive liver fibrosis assessment tools are available. Here, we evaluated the performance of the asparagine aminotransferase-to-platelet ratio index (APRI), the fibrosis-4 index (FIB-4), transient elastography (TE), and the globulin-platelet (GP) ratio for identifying liver fibrosis in patients with hepatitis B virus (HBV) infection.

Methods: A total of 146 patients were assessed using TE, FIB-4, APRI, the GP ratio, and liver biopsy. Three patient grouping methods were applied: any fibrosis (AF; F0 vs. F1/2/3/4); moderate fibrosis (MF; F0/1 vs. F2/3/4); and severe fibrosis (SF; F0/1/2 vs. F3/4). Receiver operating characteristic (ROC) curve analysis, univariate analyses, and multivariate logistic regression were conducted.

Results: Regardless of patient-grouping method, the area under the curve (AUC) of TE and the GP ratio were similar. Using the AF grouping method, the GP ratio showed superior performance compared with APRI and FIB-4: the AUCs for the GP ratio, TE, APRI, and FIB-4 were 0.76, 0.75, 0.70, and 0.66, respectively. Using the MF grouping method, the GP ratio also showed superior performance compared with APRI and FIB-4: the AUCs for the GP ratio, TE, APRI, and FIB-4 were 0.66, 0.68, 0.57, and 0.53, respectively. Using the SF grouping method, the AUCs for the GP ratio, TE, APRI, and FIB-4 were not significantly different.

Conclusion: Compared with FIB-4 and APRI, the GP ratio had higher accuracy for identifying liver fibrosis, especially early-stage fibrosis, in patients with HBV infection.

Keywords: Globulin-platelet ratio; hepatitis; liver fibrosis.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
ROC curves of noninvasive diagnostic methods for liver fibrosis using the AF grouping method. AF, any fibrosis (F0 vs. F1/2/3/4)
FIGURE 2
FIGURE 2
ROC curves of noninvasive diagnostic methods for liver fibrosis using the MF grouping method. MF, moderate fibrosis (F0/1 vs. F2/3/4)
FIGURE 3
FIGURE 3
ROC curves of noninvasive diagnostic methods for liver fibrosis using the SF grouping method. SF, severe fibrosis (F0/1/2 vs. F3/4)
See this image and copyright information in PMC

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