Although the liver has regeneration capacity, chronic liver injury would lead to liver fibrosis. 1 Advanced fibrosis would result in liverrelated mortality: liver failure, and hepatocellular carcinoma. 2 The diagnosis of early liver fibrosis and accurate fibrosis stage was important for the screening, diagnosis, and treatment of liver fibrosis.Liver biopsy was the gold method to examine fibrosis. However, it has several implications: inconvenience for doctors and patients, invasive method which could cause pain and bleeding, and indeterminacy due to that specimen was only a very small part of the liver. 3 Non-invasive tests for fibrosis were developed, which include radiologic and serum-based test. Radiologic examinations include ultrasonography, magnetic resonance imaging, and elastography; however, they also have some implications: obesity impact, inconvenience, and high cost. 4 Serum-based methods include serum algorithm