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Development and validation of a novel score for fibrosis staging in patients with chronic hepatitis B
Author(s) -
Wu Daxian,
Rao Qunfang,
Chen Wenqian,
Ji Feiyang,
Xie Zhongyang,
Huang Kaizhou,
Chen Er'mei,
Zhao Yalei,
Ouyang Xiaoxi,
Zhang Sainan,
Jiang Zhengyi,
Zhang Lingjian,
Xu Linjie,
Gao Hainv,
Li Lanjuan
Publication year - 2018
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.13756
Subject(s) - receiver operating characteristic , medicine , fibrosis , cirrhosis , aspartate transaminase , gastroenterology , liver biopsy , area under the curve , chronic hepatitis , alanine transaminase , pathology , biopsy , immunology , alkaline phosphatase , biology , biochemistry , virus , enzyme
Background & Aims Non‐invasive assessment methods for liver fibrosis are urgently needed. The present study aimed to develop a novel diagnostic model for fibrosis staging in patients with chronic hepatitis B. Methods A cross‐sectional set of 417 chronic hepatitis B patients who underwent liver biopsy was enrolled and the METAVIR score was adopted as the reference of fibrosis staging. Results Among thyroid hormones, only the level of free tetraiodothyronine ( FT 4) decreased gradually with the METAVIR fibrosis score ( P < .001). FibroStage, a novel diagnosis model that incorporates data on FT 4, platelets, cholinesterase, gamma‐glutamyl transpeptidase, and age, was developed using the deriving set (n = 219). For the diagnosis of significant fibrosis, the FibroStage model had a significantly higher area under the receiver operating curve than did the FibroIndex, Forn, and Lok models (all of P < .01) and tended to better than the fibrosis‐4 ( P = .0791) but comparable with the aspartate transaminase‐to‐platelet ratio index model ( P = .1694). For the diagnosis of advanced fibrosis, FibroStage had a higher area under the receiver operating curve than did the aspartate transaminase‐to‐platelet ratio index, FibroIndex, Forn, and Lok models (all of P < .05) and had a comparable area under the receiver operating curve with the fibrosis‐4 model ( P = .2109). For the diagnosis of cirrhosis, the area under the receiver operating curve of FibroStage was higher than those of the aspartate transaminase‐to‐platelet ratio index, fibrosis‐4, FibroIndex, and Lok (all of P < .05) models and was comparable with Forn ( P = .1649). These results was validated by a validation set (n = 198). Conclusion FT 4 may be an indicator for fibrosis staging in chronic hepatitis B patients. FibroStage is a better model than aspartate transaminase‐to‐platelet ratio index, fibrosis‐4, FibroIndex, Forn, and Lok for the comprehensively diagnosis of significant and advanced fibrosis and cirrhosis.