Simpler score of routine laboratory tests predicts liver fibrosis in patients with chronic hepatitis B

Abstract

Background and Aim: In recent years, a great interest has been dedicated to the development of noninvasive predictive models to substitute liver biopsy for fibrosis assessment and follow-up. Our aim was to provide a simpler model consisting of routine laboratory markers for predicting liver fibrosis in patients chronically infected with hepatitis B virus (HBV) in order to optimize their clinical management. Methods: Liver fibrosis was staged in 386 chronic HBV carriers who underwent liver biopsy and routine laboratory testing. Correlations between routine laboratory markers and fibrosis stage were statistically assessed. After logistic regression analysis, a novel predictive model was constructed. This S index was validated in an independent cohort of 146 chronic HBV carriers in comparison to the SLFG model, Fibrometer, Hepascore, Hui model, Forns score and APRI using receiver operating characteristic (ROC) curves. Results:The diagnostic values of each marker panels were better than single routine laboratory markers. The S index consisting of g-glutamyltransferase (GGT), platelets (PLT) and albumin (ALB) (S-index: 1000 ¥ GGT/(PLT ¥ ALB

The relation between liver histopathology and GGT levels in viral hepatitis: More important in hepatitis B

“…In one such study, a model was developed with five biochemical markers, including aminotransferases and GGT, and this model was stated to be a valuable marker of hepatitis B-related activity and fibrosis (17). Another study developing a simple model including routine laboratory markers showed that a model involving GGT, thrombocyte, and albumin yielded significant results in determining the degree of fibrosis in patients with chronic hepatitis B (18). In a study with 70 chronic hepatitis B patients, it was concluded that GGT reflected inflammation in the liver better than ALT and AST and that GGT may have an important role in the clinical evaluation of chronic hepatitis B (19).…”

Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

“…The S index consisting of gamma-glutamyltransferase (GGT), platelets (PLT) and albumin (ALB) [S-index: 1,000 × GGT/(PLT × ALB(2)] had an AUROC of 0.81 and 0.89 for predicting significant fibrosis and cirrhosis respectively in 146 HBV patients (75).…”

Karaciğer Fibrozisinin İnvazif Olmayan Dolaylı Biyokimyasal Belirteçleri

“…Son yaklaşımlarda birden fazla biyokimyasal belirtecin kombine edilmesinin [36][37][38][39][40] bu hastalardaki tanısal doğruluğu arttıracağı ileri sürülmüştür. Ayrıca, yapılan çalışmalar incelendiğinde siroz hastalarında dolaylı biyokimyasal belirteçlerin daha iyi bir performansa sahip olduğu dikkatimizi çekmiştir 20,25,37,[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] . Son yıllarda yapılan çalışmalarda karaciğer biyopsisinden önce biyokimyasal testlerin ve indekslerin birinci basamak tarama testi olarak kullanılmasının özellikle belirgin fibrozis ve sirozun tespiti ve dışlanmasında doğru yol gösterici olup gereksiz karaciğer biyopsisi yapılmasını önleyebileceği vurgulanmıştır.…”