Noninvasive assessment of liver fibrosis with combined serum aminotransferase/platelet ratio index and hyaluronic acid in patients with chronic hepatitis B

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http://www.wjgnet.com/1007-9327/abstract_en.asp?f=7117 & v=14

Noninvasive assessment of liver fibrosis with combined serum

aminotransferase/platelet ratio index and hyaluronic acid in patients with

chronic hepatitis B

Zhang YX, Wu WJ, Zhang YZ, Feng YL, Zhou XX, Pan Q.

Department of Laboratory Medicine, Shanghai Public Health Clinical Center

Affiliated to Fudan University, 2901 Caolang Road, Jinshan District, Shanghai

201508, China. wwj1210@...

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.