ABSTRACT
OBJECTIVE: We intended to evaluate the diagnostic efficiency of red cell distribution width to platelet ratio(RPR),and compare it with other three markers of fibrosis-4(FIB-4), aspartate aminotransferase-to-platelet-ratio-index(APRI) and aspartateaminotransferase-to-alanine aminotransferase ratio(AAR) for judging liver fibrosis and fibrosis severity in patients with chronic hepatitis B(CHB). METHODS: who had not received antiviral treatment met the requirements of this cross-sectional study. Hematology,biochemistry, virology testing and liver biopsy were performed. Receiver-operating characteristic curves were constructed and the area under the ROC curve was calculated. RESULTS: The cut-off value for distinguishing F0-1, F2-3 and F4 was 0.079, 0.141 and 0.279,respectively(P<0.001) for RPR; 1.194, 3.703 and 4.383(P<0.001) for FIB-4; 0.384, 0.660 and 1.441, respectively(P<0.001) for APRI; and 0.915, 0.850 and 0.960(P=0.706) for AAR. The sensitivity was 76.09% for RPR, 78.26% for FIB-4, 97.83% for AAR and80.43% for APRI; specificity was 81.48% for RPR, 75.93% for FIB-4, 14.81% for AAR and 80.43% for APRI; the AUROC was 0.787 for RPR, 0.778 for FIB-4, 0.540 for AAR and 0.759 for APRI. The common cut-off value was 0.11, 1.94, 0.60 and 0.59 for RPR, FIB-4, AAR and APRI respectively. CONCLUSION: RPR, FIB-4 and APRI have good efficiency in appraising significant and severe fibrosis in patients with CHB, however RPR is superior to FIB-4 and FIB-4 is superior to APRI, therefore, RPR is a better index in evaluating liver cirrhosis.