The predictive values of three noninvasive indices in diagnosis of liver fibrosis in patients with chronic hepatitis B: a comparative study / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the values of FibroTouch, FIB-4 index, and aspartate aminotransferase-to-platelet ratio index (APRI) in the diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB). MethodsA total of 148 patients with CHB who visited Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region and underwent liver biopsy from September 2013 to May 2015 were enrolled and divided into groups according to fibrosis stage. All the patients underwent blood biochemical examination, routine blood tests, and FibroTouch measurement. Then FIB-4 and APRI were calculated, and liver stiffness was recorded. The receiver operating characteristic (ROC) curve was used to calculate the area under the ROC curve (AUC) and determine the cut-off value, sensitivity, and specificity. Chi-square test was used for comparison between two groups, and the Pearson rank correlation analysis was also performed. ResultsFibroTouch, APRI, and FIB-4 were well correlated with fibrosis stage (r=0.628, 0.486, and 0482, respectively, all P＜0.01). In the marked liver fibrosis (≥S2) group and liver cirrhosis (S4) group, FibroTouch had the best diagnostic performance, with AUCs of 0.84 and 0.93, respectively, followed by APRI, which had AUCs of 0.79 and 0.87, respectively; FIB-4 index had the worst diagnostic performance, with AUCs of 0.77 and 0.84, respectively. In patients with a fibrosis stage of ≥S2 or S4, FibroTouch had a better diagnostic value than APRI and FIB-4 (Z=21.589, P＜0.001; Z=18.896, P＜0.001; Z=11.192, P=0.001; Z=16.891, P＜0.001), and APRI had a better diagnostic value than FIB-4 (Z=46.918, P＜0.001; Z=35.334, P＜0.001). ConclusionFibroTouch can accurately evaluate the presence of liver fibrosis and fibrosis degree and help most patients avoid invasive liver biopsy.