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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 14, 2008; 14(46): 7117-7121
Published online Dec 14, 2008. doi: 10.3748/wjg.14.7117
Noninvasive assessment of liver fibrosis with combined serum aminotransferase/platelet ratio index and hyaluronic acid in patients with chronic hepatitis B
You-Xiang Zhang, Wen-Juan Wu, Yun-Zhi Zhang, Yan-Ling Feng, Xin-Xi Zhou, Qi Pan
You-Xiang Zhang, Yun-Zhi Zhang, Xin-Xi Zhou, Qi Pan, Department of Hepatitis, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai 201508, China
Wen-Juan Wu, Department of Laboratory Medicine, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai 201508, China
Yan-Ling Feng, Department of Pathology, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai 201508, China
Author contributions: Zhang YX and Wu WJ contributed equally to this work; Zhang YX designed the research; Wu WJ and Feng YL performed the research; Zhang YZ, Zhou XX and Pan Q analyzed the data; Zhang YX and Wu WJ wrote the paper.
Correspondence to: Dr. Wen-Juan Wu, Department of Laboratory Medicine, Shanghai Public Health Clinical Center Affiliated to Fudan University, 2901 Caolang Road, Jinshan District, Shanghai 201508, China. wwj1210@126.com
Telephone: +86-21-57248782 Fax: +86-21-57248787
Received: August 11, 2008
Revised: November 10, 2008
Accepted: November 17, 2008
Published online: December 14, 2008
Abstract

AIM: To construct a noninvasive assessment model consisting of routine laboratory data to predict significant fibrosis and cirrhosis in patients with chronic hepatitis B (CHB).

METHODS: A total of 137 consecutive patients with CHB who underwent percutaneous liver biopsy were retrospectively analyzed. These patients were divided into two groups according to their aminotransferase (ALT) level. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), the likelihood ratio (LR) of aminotransferase/platelet ratio index (APRI) ≥ 1.5 or < 1.5 in combination with different hyaluronic acid (HA) cut-off points were calculated for the presence of moderate to severe fibrosis/cirrhosis (fibrosis stages 2 and 4) and no to mild fibrosis/cirrhosis (fibrosis stages 0 and 1).

RESULTS: The APRI correlated with fibrosis stage in CHB patients. The APRI ≥ 1.5 in combination with a cut-off HA cut-off point > 300 ng/mL could detect moderate to severe fibrosis (stages 2-4) in CHB patients. The PPV was 93.7%, the specificity was 98.9%. The APRI < 1.5 in combination with different HA cut-off points could not detect no to mild fibrosis in CHB patients.

CONCLUSION: The APRI ≥ 1.5 in combination with a HA cut-off point > 300 ng/mL can detect moderate to severe fibrosis (stages 2-4) in CHB patients.

Keywords: Noninvasive assessment, Liver fibrosis, Chronic hepatitis B, Aminotransferase/platelet ratio index, Hyaluronic acid