Open AccessPerformance of noninvasive tools for identification of minimal liver fibrosis in patients with hepatitis B virus infection
Author(s) -
Zhang Hong,
Shi XinXing,
Wang Lin,
Zeng Yilan,
Kang Xintong,
Huang Liang
Publication year - 2021
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.23960
Subject(s) - receiver operating characteristic , medicine , fibrosis , gastroenterology , liver biopsy , transient elastography , liver fibrosis , univariate analysis , biopsy , multivariate analysis
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.