Use of aspartate aminotransferase to platelet ratio to reduce the need for FibroScan in the evaluation of liver fibrosis

Wong, Stephanie; Huynh, Dep; Zhang, Frank

doi:10.4254/wjh.v9.i17.791

Cited by 15 publications

(15 citation statements)

References 24 publications

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“…It is not unusual for threshold values to differ between published data. Differences in patient populations, including the prevalence of significant fibrosis, cirrhosis, and reference ranges used for AST and ALT levels, may explain these discrepancies [17]. Our data included a large number of patients with advanced fibrosis (63.5%) or cirrhosis (46%), quite a high proportion compared to literature data.…”

Section: Discussionmentioning

confidence: 99%

Liver fibrosis staging with combination of APRI and FIB-4 scoring systems in chronic hepatitis C as an alternative to transient elastography

Papadopoulos¹,

Vasileiadi

Papavdi

et al. 2019

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Background: Liver disease severity must be determined before treatment of chronic hepatitis C (CHC). We evaluated the diagnostic performance of the APRI and FIB-4 scores compared to transient elastography liver stiffness (TE-LS) in detecting significant fibrosis (F3) or cirrhosis (F4). Methods: We retrospectively enrolled 575 patients with CHC who underwent TE-LS between May 2014 and September 2018: 365 (63.5%) male, mean age 51.54±12.4 years. APRI and FIB-4 scores were compared to TE-LS. Results : One hundred patients (17.5%) had TE-LS values between 9 and 11.9 kPa, and were classified as F3, while 265 (46%) were classified as F4 (TE-LS ≥12 kPa). APRI and FIB-4 scores predicted F4 patients adequately using cutoff values of 0.65 (sensitivity 85.5%, specificity 77%) and 1.63 (sensitivity 91%, specificity 77%), respectively. Cutoff values of 0.64 for APRI and 1.46 for FIB-4 predicted F3/F4 patients (sensitivity 72% and 81.5%; specificity 83% and 79%, respectively). The use of these cutoff values with APRI and FIB-4 in combination adequately predicted patients with significant fibrosis or cirrhosis (positive predictive value 91.5%), while cutoff values of 0.3 and 0.98, respectively, predicted F1/F2 patients with specificity 94.5% and sensitivity 26.5%, suggesting that in 58.5% of patients TE-LS could possibly be avoided. Conclusions: The APRI/FIB-4 combination performed well in predicting significant fibrosis, while FIB-4 performed well in predicting cirrhosis. These noninvasive biochemical markers could be used as screening tools instead of LS measurement, which is not widely available. Further prospective validation studies are required to confirm this finding.

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Section: Discussionmentioning

confidence: 99%

Liver fibrosis staging with combination of APRI and FIB-4 scoring systems in chronic hepatitis C as an alternative to transient elastography

Papadopoulos¹,

Vasileiadi

Papavdi

et al. 2019

aog

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“…Liver biopsy is considered the criterion standard for determination of the stages of fibrosis in chronic liver diseases; however, it is difficult to perform or repeat in clinical practice [ 33 ]. Several non-invasive markers have been applied in clinical practice to evaluate the stage of fibrosis in liver diseases [ 22 , 34 ]. In recent years, FibroScan has been thoroughly investigated and has been shown to successfully detect fibrosis in chronic hepatitis [ 23 – 25 ].…”

Section: Discussionmentioning

confidence: 99%

Transient Elastography (FibroScan) Performs Better Than Non-Invasive Markers in Assessing Liver Fibrosis and Cirrhosis in Autoimmune Hepatitis Patients

Guo

Zheng

et al. 2017

Med Sci Monit

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BackgroundAutoimmune hepatitis (AIH) is an immune-mediated chronic liver disease that can lead to severe fibrosis and cirrhosis. Transient elastography (TE, FibroScan) can assess the fibrotic stages of chronic liver diseases by liver stiffness measurement (LSM). Studies on the diagnostic accuracy of FibroScan for the detection of fibrosis in AIH patients are still limited.Material/MethodsThis study enrolled 108 AIH patients who underwent liver biopsies. Using the METAVIR scoring system as the reference, Spearman’s rank correlation was performed to explore the relationship between the markers and stages of fibrosis. The area under the receiver operating characteristic curve (AUROC) was used to evaluate the diagnostic accuracy. The optimal LSM cut-off values for predicting the stages of fibrosis were calculated.ResultsLSM was superior to other non-invasive markers in differentiating the stages of fibrosis in AIH patients. AUROC value of LSM was 0.885 for stage F2, 0.897 for stage F3, and 0.878 for stage F4. The optimal LSM cut-off value was 6.27 kPa for stage F2, 8.18 kPa for F3, and 12.67 kPa for F4.ConclusionsFibroScan is a valuable non-invasive method for the evaluation of liver fibrosis of AIH patients.

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“…9 Study conducted Wong et al, on 3619 patients on Hepatitis B and Hepatitis C infected Patients and concluded that APRI score is a good marker and can be used as alternate noninvasive marker in predicting fibrosis of liver. 16…”

Section: Discussionmentioning

confidence: 99%

Correlation between APRI Index, MELD Score and Child Pugh Score in cirrhosis of liver

Prakash

Shetty

2019

Int J Adv Med

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Background: Liver cirrhosis is the end result of chronic liver injury and is one of the most common cause of morbidity and mortality. Several scorings are available to predict the severity and prognosis of liver cirrhosis. This study aims to calculate APRI index, MELD score and child Pugh score in cirrhosis patients and to find the correlation between them.Methods: This is the Cross-sectional study on 100 patients confirmed with cirrhosis of liver. Cirrhosis due to alcohol, Hepatitis B and C, autoimmune, Cryptogenic, NAFLD, were included in the study. APRI Index, MELD Score and Child Pugh Score were calculated, and the correlation was obtained.Results: This study found out the relationship between APRI index, MELD Score and Child Pugh Score with significant p value. The study also showed that all the three scores were raised with patients who had complication of cirrhosis like encephalopathy, refractory ascites. Among those who had complication like grade 3 or 4 encephalopathy, APRI index had a mean value of 3.4, Child Pugh had a mean score of 13.2, and MELD had a mean score of 36.08 with standard deviation of 2.0, 1.5, 6.0 respectively.Conclusions: APRI index is an independent predictor of morbidity and mortality. The prognostic performance of all 3 was comparable, Hence APRI index can be used as an alternative scoring which is cost effective and objective method in predicting the severity and prognosis in cirrhosis of liver.

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Use of aspartate aminotransferase to platelet ratio to reduce the need for FibroScan in the evaluation of liver fibrosis

Cited by 15 publications

References 24 publications

Liver fibrosis staging with combination of APRI and FIB-4 scoring systems in chronic hepatitis C as an alternative to transient elastography

Liver fibrosis staging with combination of APRI and FIB-4 scoring systems in chronic hepatitis C as an alternative to transient elastography

Transient Elastography (FibroScan) Performs Better Than Non-Invasive Markers in Assessing Liver Fibrosis and Cirrhosis in Autoimmune Hepatitis Patients

Correlation between APRI Index, MELD Score and Child Pugh Score in cirrhosis of liver

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