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Red cell volume distribution width‐to‐platelet ratio in assessment of liver fibrosis in patients with chronic hepatitis B
Author(s) -
Lee Hye Won,
Kang Wonseok,
Kim Beom Kyung,
Kim Seung Up,
Park Jun Yong,
Kim Do Young,
Ahn Sang Hoon,
Park Young Nyun,
Han Kwang Hyub
Publication year - 2016
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12868
Subject(s) - red blood cell distribution width , mean platelet volume , medicine , cirrhosis , transient elastography , receiver operating characteristic , gastroenterology , platelet , chronic liver disease , liver biopsy , fibrosis , pathology , biopsy , liver fibrosis
Background & Aims Precise assessment of liver fibrosis is necessary in patients with chronic liver disease. We investigated the performance of red cell volume distribution width‐to‐platelet ratio for the assessment of liver fibrosis in patients with chronic hepatitis B. Methods A total of 482 consecutive patients with chronic hepatitis B who underwent liver biopsy between October 2005 and May 2014 were recruited. Liver stiffness was measured using transient elastography. FIB ‐4 score, red cell volume distribution width‐to‐platelet ratio and the aspartate aminotransferase‐to‐platelet ratio index were also assessed. Results A total of 271 (56.2%) patients were males. The median age was 44 years. F1, F2, F3 and F4 fibrosis stages were identified in 68 (14.1%), 137 (28.4%), 64 (13.3%) and 213 (44.2%) of the patients respectively. The mean red cell volume distribution width‐to‐platelet ratio increased with liver fibrosis severity: F1, 0.065; F2, 0.077; F3, 0.097 and F4, 0.121 ( P < 0.01). The area under the receiver operating characteristic curve of the red cell volume distribution width‐to‐platelet ratio for predicting significant fibrosis (≥F2) was 0.747. This result was inferior to transient elastography (0.866, P = 0.004), but comparable to FIB ‐4 (0.782, P = 0.427) and aspartate aminotransferase‐to‐platelet ratio index (0.716, P = 0.507). The area under the receiver operating characteristic curve of red cell volume distribution width‐to‐platelet ratio for predicting cirrhosis (F4) was 0.811, which was inferior to liver stiffness (0.915, P < 0.001), but comparable to FIB ‐4 (0.804, P = 0.805) and superior to aspartate aminotransferase‐to‐platelet ratio index (0.680, P < 0.001). Conclusions The accuracy of red cell volume distribution width‐to‐platelet ratio was acceptable for the assessment of liver fibrosis in patients with chronic hepatitis B. When transient elastography is not available, red cell volume distribution width‐to‐platelet ratio assessment is a simple method that can be used to reduce the need for liver biopsy.