Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jan 28, 2010; 16(4): 501-507
Published online Jan 28, 2010. doi: 10.3748/wjg.v16.i4.501
Staging of liver fibrosis in chronic hepatitis B patients with a composite predictive model: A comparative study
Sheng-Di Wu, Ji-Yao Wang, Lei Li
Sheng-Di Wu, Ji-Yao Wang, Lei Li, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Author contributions: Wang JY designed and conducted the study, accessed all the data and took the full responsibility for the data analysis; Wu SD and Li L collected and analyzed the data; Wu SD wrote the manuscript; Wang JY revised the paper and improved the English; all authors participated in reviewing and revising the manuscript.
Supported by Grant for Master Degree Students of Fudan University
Correspondence to: Ji-Yao Wang, Professor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China. wang.jiyao@gmail.com
Telephone: +86-21-64041990 Fax: +86-21-64432583
Received: October 28, 2009
Revised: December 9, 2009
Accepted: December 16, 2009
Published online: January 28, 2010
Abstract

AIM: To evaluate the efficacy of 6 noninvasive liver fibrosis models and to identify the most valuable model for the prediction of liver fibrosis stage in chronic hepatitis B (CHB) patients.

METHODS: Seventy-eight CHB patients were consecutively enrolled in this study. Liver biopsy was performed and blood serum was obtained at admission. Histological diagnosis was made according to the METAVIR system. Significant fibrosis was defined as stage score ≥ 2, severe fibrosis as stage score ≥ 3. The diagnostic accuracy of 6 noninvasive liver fibrosis models, including serum aspartate aminotransferase (AST) to platelet ratio index (APRI), FIB-4, Forn’s index, Fibrometer, Hepascore, and Shanghai Liver Fibrosis Group’s index (SLFG), was investigated.

RESULTS: The APRI, FIB-4 and Forn’s index under receiver operating characteristic curve (AUROC) for significant fibrosis were 0.71, 0.75 and 0.79, respectively, with a diagnosis accuracy of 67%, 77% and 80%, respectively, and 0.80, 0.87 and 0.86, respectively, under the AUROC for severe fibrosis. The Hepascore, SLFG, and Fibrometer were 0.80, 0.83 and 0.85, respectively under the AUROC for significant fibrosis (P < 0.01). The diagnosis accuracy of Hepascore and SLFG was 86% and 88%, respectively. The Hepascore, SLFG, and Fibrometer were 0.95, 0.93, and 0.94, respectively, under the AUROC for severe fibrosis (P < 0.01).

CONCLUSION: The models containing direct serum markers have a better diagnostic value than those not containing direct serum markers.

Keywords: Chronic hepatitis B; Liver fibrosis; Serum marker; Noninvasive model; Receiver operating curve