Year 2015 / Volume 107 / Number 12
Original
The diagnostic value of a globulin/platelet model for evaluating liver fibrosis in chronic hepatitis B patients

740-744

DOI: 10.17235/reed.2015.3851/2015

Banu Demet Coskun, Engin Altinkaya, Eylem Sevinc, Mustafa Ozen, Hatice Karaman, Ahmet Karaman, Orhan Poyrazoglu,

Abstract
Background: Liver biopsy, which is considered the best method for evaluating hepatic fibrosis, has important adverse events. Therefore, non-invasive tests have been developed to determine the degree of hepatic fibrosis in patients with chronic hepatitis B. Aim: To verify the usefulness of a new fibrosis index the globulin/platelet model in patients with chronic hepatitis B and to compare it with other noninvasive tests for predicting significant fibrosis. This study was the second to evaluate the globulin/platelet model in HBV patients. Methods: We retrospectively investigated 228 patients with chronic hepatitis B who performed liver biopsy from 2013 to 2014. The globulin/platelet model, APGA [AST/Platelet/Gamma-glutamyl transpeptidase/Alfa-fetoprotein], FIB4, fibrosis index, cirrhosis discriminate score, and Fibro-quotient were calculated, and the diagnostic accuracies of all of the fibrosis indices were compared between the F0-2 (no-mild fibrosis) and F3-6 (significant fibrosis) groups. Results: All of the noninvasive markers were significantly correlated with the stage of liver fibrosis (p < 0,001). To predict significant fibrosis (F ≥ 3), the area under the curve (95% CI) was found to be greatest for APGA (0.83 [0.74-0.86]), followed by FIB-4 (0.75[0.69-0.80]), the globulin/platelet model (0.74 [0.68-0.79]), fibrosis index (0.72 [0.6-0.78], cirrhosis discriminate score (0.71 [0.64-0.76]) and Fibro-quotient (0.62 [0.55-0.7]). The area under the receiver operating characteristic curves of APGA was significantly higher than that of the other noninvasive fibrosis markers (p < 0.05). Conclusions: While the APGA index was found to be the most valuable test for the prediction significant fibrosis in patients with chronic hepatitis B, GP model was the thirth valuable test. Therefore, we recommended that APGA could be used instead of the GP model for prediction liver fibrosis.
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References
1. Lin J, Wu JF, Zhang Q, et al. Virus-related liver cirrhosis: Molecular basis and therapeutic options. World J Gastroenterol 2014: 7; 20: 6457-69.
2. Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology 2007; 45: 507–39.
3. Degertekin B, Lok AS. Indications for therapy in hepatitis B. Hepatology 2009; 49: 129–37.
4. Sarin SK, Kumar A, Angus PW, et al. Liver fibrosis: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL). Hepatol Int 2009; 3: 323–33.
5. Liaw YF, Sung JJ, Chow WC, et al. Lamivudine for patients with chronic hepatitis B and advanced liver disease. N Engl J Med 2004; 351:1521–31.
6. Lindor KD, Bru C, Jorgensen RA, et al. The role of ultrasonography and automatic-needle biopsy in outpatient percutaneous liver biopsy. Hepatology 1996;23: 1079 –83.
7. Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med 2001; 344: 495–500.
8. Fung J, Lai CL, Fong DY, et al. Correlation of liver biochemistry with liver stifness in chronic hepatitis B and development of a predictive model for liver fibrosis. Liver Int 2008; 28: 1408-16.
9. Bonacini M, Hadi G, Govindarajan S, et al. Utility of a discriminant score for diagnosing advanced fibrosis or cirrhosis in patients with chronic hepatitis C virus infection . Am J Gastroenterol 1997; 92: 1302–4.
10. Ohta T, Sakaguchi K, Fujiwara A, et al. Simple surrogate index of the fibrosis stage in chronic hepatitis C patients using platelet count and serum albumin level. Acta Med Okayama 2006; 60: 77-84.
11. Islam S, Antonsson L, Westin J , et al. Cirrhosis in hepatitis C virus-infected patients can be excluded using an index of standard biochemical serum markers . Scand J Gastroenterol 2005; 40 : 867–72.
12. Hsieh YY, Tung SY, Lee IL, et al. Fibro Q: an easy and useful noninvasive test for predicting liver fibrosis in patients with chronic viral hepatitis. Chang Gung Med J 2009; 32: 614–22.
13. Liu XD, Wu LJ, Liang J, et al. Globulin-platelet model predicts minimal fibrosis and cirrhosis in chronic hepatitis B virus infected patients. World J Gastroenterol 2012; 18 : 2784-92.
14. Seto WK, Lee CF, Lai CL, et al. A new model using routinely available clinical parameters to predict significant liver fibrosis in chronic hepatitis B. PLoS One 2011; 6:e23077.
15. Sterling RK, Lissen E, Clumeck N, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology 2006; 43: 1317–25.
16. Vallet-Pichard A, Mallet V, Nalpas B, et al. FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. Comparison with liver biopsy and fibrotest. Hepatology 2007; 46: 32–63.
17. Kim BK, Kim do Y, Park JY, et al. Validation of FIB-4 and comparison with other simple noninvasive indices for predicting liver fibrosis and cirrhosis in hepatitis B virus-infected patients. Liver Int 2010; 30: 546-53.
18. Ma J, Jiang Y, Gong G. Evaluation of seven noninvasive models in staging liver fibrosis in patients with chronic hepatitis B virus infection. Eur J Gastroenterol Hepatol 2013; 25: 428-34.
19. Watt K, Uhanova J, Gong Y, et al. Serum immunoglobulins predict the extent of hepatic fibrosis in patients with chronic hepatitis C virus infection. J Viral Hepat 2004; 11: 251–6.
20. Schmilovitz-Weiss H, Tovar A, Halpern M, et al. Predictive value of serum globulin levels for the extent of hepatic fibrosis in patients with chronic hepatitis B infection. J Viral Hepat 2006; 13: 671-7.
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Coskun B, Altinkaya E, Sevinc E, Ozen M, Karaman H, Karaman A, et all. The diagnostic value of a globulin/platelet model for evaluating liver fibrosis in chronic hepatitis B patients. 3851/2015


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Publication history

Received: 16/05/2015

Accepted: 08/08/2015

Online First: 22/10/2015

Published: 03/12/2015

Article revision time: 53 days

Article Online First time: 159 days

Article editing time: 201 days


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