Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 10:12:653751.
doi: 10.3389/fphar.2021.653751. eCollection 2021.

Prognostic Value of Inflammatory Indicators in Chronic Hepatitis B Patients With Significant Liver Fibrosis: A Multicenter Study in China

Xiujuan Zhang  1 , Yusheng Jie  2 , Zemin Wan  3 , Shanshan Lin  1 , Yingxian Li  4 , Ming Lin  1 , Shuduo Wu  1 , Xiaoju Wu  1 , Meijie Shi  1 , Huanming Xiao  1 , Minling Cao  1 , Jiao Gong  5 , Xiaoling Chi  1
Affiliations

Prognostic Value of Inflammatory Indicators in Chronic Hepatitis B Patients With Significant Liver Fibrosis: A Multicenter Study in China

Xiujuan Zhang et al. Front Pharmacol. .

Abstract

Diagnosis of significant liver fibrosis is essential to facilitate the optimal treatment decisions and improve prognosis in patients with chronic hepatitis B (CHB). We aimed to evaluate the value of inflammatory indicators and construct a nomogram that effectively predicts significant liver fibrosis among CHB patients. 563 CHB patients from two centers in China from 2014 to 2019 were divided into three cohorts (development, internal validation, and independent validation cohorts), assigned into cases with significant fibrosis (liver fibrosis stages ≥2) and those without. Multiple biochemical and serological inflammatory indicators were investigated. Inflammatory indicators, Alanine aminotransferase (ALT) and aspartate aminotransferase (AST), were significantly associated with significant liver fibrosis in CHB patients but limited predictive performance, and then we combined them with prothrombin time activity percentage (PTA) and liver stiffness measurement (LSM) were identified by multivariate logistic regression analysis. Based on these factors, we constructed the nomogram with excellent performance. The area under the receiver operating characteristic curve (AUROC) for the nomogram in the development, internal validation, and independent validation cohorts were 0.860, 0.877, and 0.811, respectively. Our nomogram based on ALT and AST that had excellent performance in predicting significant fibrosis of CHB patients were constructed.

Keywords: chronic hepatitis B; diagnosis; inflammatory indicators; liver fibrosis; predicting tool.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Construction of the AAPL nomogram (ALT, AST, PTA, and LSM) for predicting significant liver fibrosis in patients with CHB. (A) Flowchart of the study sample and AAPL nomogram construction. (B) Selection of fundamental clinical indicators using least absolute shrinkage and selection operator (LASSO) regression analysis. (C) Cross-validation plot for the penalty term. (D) AAPL nomogram for predicting significant fibrosis in patients with CHB.
FIGURE 2
FIGURE 2
The area under the receiver operating characteristic (AUROC) curve and calibration curve for the AAPL nomogram (ALT, AST, PTA, and LSM). AUROC values of the AAPL nomogram for predicting significant fibrosis in patients with CHB in the (A) development cohort (AUROC = 0.86), (B) internal validation cohort (AUROC = 0.877), and (C) independent validation cohort (AUROC = 0.811). Calibration curve of the AAPL nomogram for predicting significant fibrosis in patients with CHB in the (D) development cohort, (E) internal validation cohort, and (F) independent validation cohort.
FIGURE 3
FIGURE 3
Decision curve analysis (DCA) and clinical impact curve analysis (CICA) of the AAPL nomogram (ALT, AST, PTA, and LSM). DCA of the AAPL nomogram for predicting significant fibrosis in patients with CHB in the (A) development cohort, (B) internal validation cohort, and (C) independent validation cohort. CICA of the AAPL nomogram for predicting significant fibrosis in patients with CHB in the (D) development cohort, (E) internal validation cohort, and (F) independent validation cohort.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Castéra L., Foucher J., Bernard P. H., Carvalho F., Allaix D., Merrouche W., et al. (2010). Pitfalls of Liver Stiffness Measurement: a 5-year Prospective Study of 13,369 Examinations. Hepatology 51, 828–835. 10.1002/hep.23425 - DOI - PubMed
    1. Chalasani N., Younossi Z., Lavine J. E., Charlton M., Cusi K., Rinella M., et al. (2018). The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance from the American Association for the Study of Liver Diseases. Hepatology 67, 328–357. 10.1002/hep.29367 - DOI - PubMed
    1. Duan W. J., Wang X. Z., Ma A. L., Shang J., Nan Y. M., Gao Z. L., et al. (2020). Multicenter Prospective Study to Validate a New Transient Elastography Device for Staging Liver Fibrosis in Patients with Chronic Hepatitis B. J. Dig. Dis. 21, 519–525. 10.1111/1751-2980.12924 - DOI - PubMed
    1. El-Serag H. B. (2012). Epidemiology of Viral Hepatitis and Hepatocellular Carcinoma. Gastroenterology 142, 1264–e1. 10.1053/j.gastro.2011.12.061 - DOI - PMC - PubMed
    1. El-Serag H. B. (2011). Hepatocellular Carcinoma. N. Engl. J. Med. 365, 1118–1127. 10.1056/NEJMra1001683 - DOI - PubMed

LinkOut - more resources