Value of FibroScan combined with gamma-glutamyl transpeptidase-to-platelet ratio in predicting liver fibrosis in patients with chronic hepatitis B: A preliminary study / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the value of FibroScan combined with gamma-glutamyl transpeptidase-to-platelet ratio (GPR) in predicting liver fibrosis stage in patients with chronic hepatitis B (CHB). MethodsA total of 278 patients who were diagnosed with CHB by liver biopsy in Guangzhou Eighth People’s Hospital from January 2012 to December 2016 were enrolled. The value of GPR and FibroScan used alone or in combination in predicting liver fibrosis stage (F0-F4) was analyzed. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups and the Mann-Whitney U test was used for further comparison between two groups. The Spearman’s correlation coefficient was used for correlation analysis. The area under the receiver operating characteristic curve (AUC) was used to evaluate liver fibrosis stage. ResultsWith liver biopsy as the gold standard, of all patients, 50 had stage F1 fibrosis, 104 had stage F2 fibrosis, 92 had stage F3 fibrosis, and 32 had stage F4 fibrosis. Liver stiffness measurement by FibroScan gradually increased with the increase in liver fibrosis stage (P＜0.05), and GPR also increased gradually in patients with stage F1, F2, and F3 liver fibrosis (P＜0.05). GPR and FibroScan were positively correlated with liver fibrosis (r=0.419 and 0.481, both P＜0.001), and GPR was positively correlated with FibroScan (r=0.436, P＜0.001). According to AUC, FibroScan combined with GPR had a better diagnostic efficiency than FibroScan (0.793 vs 0.739, Z=3.044, P=0.002) or GPR (0.793 vs 0.740, Z=2.389, P=0.037) alone in predicting progressive liver fibrosis (≥F3); FibroScan combined with GPR had a better diagnostic efficiency than GPR alone (0.782 vs 0714, Z=2.130, P=0.033) in predicting marked liver fibrosis (≥F2). ConclusionFibroScan combined with GPR has a certain advantage in predicting progressive liver fibrosis (≥F3) in CHB patients and can improve diagnostic efficiency.