International Journal of General Medicine (May 2022)

Retrospective Evaluation of Non-Invasive Assessment Based on Routine Laboratory Markers for Assessing Advanced Liver Fibrosis in Chronic Hepatitis B Patients

  • Wang Z,
  • Zhou Y,
  • Yu P,
  • Liu Y,
  • Mei M,
  • Bian Z,
  • Shao W,
  • Lv J,
  • Li X,
  • Lu W,
  • Xu L

Journal volume & issue
Vol. Volume 15
pp. 5159 – 5171

Abstract

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Zeyu Wang,1,* Yonghe Zhou,2,3,* Pengzhi Yu,2,3 Yonggang Liu,3,4 Mei Mei,5 Zhuo Bian,2 Wei Shao,2 Jinxia Lv,2 Xin Li,2 Wei Lu,1,3,6 Liang Xu3,6 1Department of Hepatobiliary Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin, 300060, People’s Republic of China; 2Ultrasound department, Tianjin Second People’s Hospital, Tianjin, 300192, People’s Republic of China; 3Tianjin Research Institute of Liver Diseases, Tianjin, 300192, People’s Republic of China; 4Pathology Department, Tianjin Second People’s Hospital, Tianjin, 300192, People’s Republic of China; 5Department of Gastroenterology, Tianjin Haihe Hospital, Tianjin, 300350, People’s Republic of China; 6Department of Hepatology, Tianjin Second People’s Hospital, Tianjin, 300192, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wei Lu; Liang Xu, Email [email protected]; [email protected]: At present, there is a lack of cheap, effective and convenient detection methods for hepatitis B-related liver fibrosis, especially in the developing area.Aim: To evaluate the non-invasive methods for the significant and advanced fibrosis stage in chronic hepatitis B virus (HBV) patients in basic hospitals and to assess their diagnostic utility.Methods: The study included 436 consecutive naive HBV individuals who had their livers biopsied. They were examined in one week using aspartate aminotransferase-to-aspartate aminotransferase ratio (AAR), age-platelet index (API), aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis-4 (FIB-4), Forns, gamma-glutamyl transpeptidase-to-platelet ratio (GPR), S-index and transient elastography (TE). Scheuer scoring system was used to determine the histologic fibrosis grades (S0–S4). The diagnostic effectiveness was assessed using AUROCs and the DeLong test, both of which were based on statistical comparisons.Results: For both substantial (≧S2) and advanced (≧S3) fibrosis phases, TE had good diagnostic performance in determining the hepatic fibrosis. Similar diagnostic performance was shown with Forns and S-index when it came to detecting fibrosis stages lower than S3. One model’s diagnostic value was not significantly improved by combining serum models. Correlation coefficients between clinical features and fibrosis phases were greatest for Forns (r = 0.397), S-index (r = 0.382) and TE (r = 0.535) when compared to other variables.Conclusion: This investigation showed that Forns and S-index may be helpful strategies for detecting advanced fibrosis in HBV patients admitted to community hospitals.Keywords: hepatitis B virus, non-invasive, basic hospital, transient elastography, Forns, S-index

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