| Objective:To explore the accuracy of M2 BPGi in evaluating liver fibrosis in chronic hepatitis C(CHC),compared with Fibro Scan.Methods:We retrospectively reviewed 1001 hepatitis C patients whounderwent Fibro Scan test and color doppler ultrasound at The First Hospital of Jilin University(Changchun, China). 321 patients who got fatty liver were exclusion in this study. Serum liver fibrosis markers and Liver stiffness measurement(LSM)were evaluated in 680 patients with chronic hepatitis C.We analysed the correlation between LSM and serum liver fibrosis markers. In addition, the diagnostic value of liver stiffness for predicting fibrosiswas assessed by calculating the areas under the ROC curves. The sensitivity, specificity, positive predictive value(PPV), and negative predictive value(NPV) of optimal cutoff values of M2 BPGi for the diagnosis of liver fibrosis werecalculated. Statistical analyses were performed using the IBM SPSS Statistics 22.0.Results:1.This study including 680 CHCpatients and 164 healthy controls. The median serum M2 BPGi value was significantly higher in CHCpatients(0.88(0.50-1.50)) than in controls(0.33(0.22-0.46)).2.Among CHC patients, the median serum M2 BPGi value increased in association with progression of fibrosis score as F0:0.6( 0.41-0.87),F1:1.13( 0.82-1.74), F2:1.36( 0.86-2.77), F3:1.56(1.15-2.55),F4:4.38(1.76-8.17). There were significant differences between fibrosis stages F0 and F1, and between F3 and F4(P<0.001).3.Gender, age, platelet count,Total protein, Albumin, liver function markers(AST, ALT, ALP, GGT,Total Billirubin, Total protein, Albumin), AFP, HA, LN, CIV, M2 BPGi, FIB-4, APRI, AST/ALT and GPR were associated with LSM in univariateanalysis. After adjusting for potential confounders, platelet count(effect size=-0.07, P<0.05), total protein(effect size=-0.08, P<0.05), ALP(effect size=0.116, P<0.05), GGT(effect size=0.13, P<0.001), total billirubin(effect size=0.111, P<0.05), HA(effect size=0.137, P<0.001),CIV(effect size=0.099, P<0.05),AFP(effect size=0.069, P<0.05) and M2BPGi(effect size=0.275, P<0.001) were independently associated with LSM on multivariate analysis.4.The area under the receiver operating characteristic curve(AUC)values of M2 BPGi for fibrosis stage ≥F1, ≥F2, ≥F3 and ≥F4were 0.855, 0.854, 0.864 and 0.904, respectively. The cutoff values were 0.935, 1.155, 1.165 and 1.315. The AUC for the diagnosis of early fibrosis(F≥1) using serum M2 BPGi values(0.855)was almost comparable to that using APRI examination(0.854,P=0.984), but was superior to the other surrogate markers,including FIB-4(0.748, P<0.001) and GPR(0.815, P=0.042).The AUC for the diagnosis of significant fibrosis(F≥2) using serum M2 BPGi values(0.854)was almost comparable to that using GPR(0.844, P=0.615)and APRI( 0.872, P=0.335) examination, but was superior to FIB-4( 0.807, P=0.032).When compared with other non-invasive markers, M2 BPGi had the greatest specificity for diagnosing severe fibrosis(F≥3) and cirrhosis(F≥4) in hepatitis C patients.Conclusions:1. The serum M2 BPGi values were significantly higher in CHCpatients than in healthy controls.2. The serum M2 BPGi values increased in association with progression of fibrosis stage.3. M2 BPGiwas the most significant factor which is associated with LSM.4.M2 BPGi may be a goodmarkertodifferentiate early(F1) from significant fibrosis(F2),but it did not performed well in classifying patients at the extremes of significant fibrosis and sever fibrosis(F2-F3). M2 BPGi had the highest accuracy for diagnosing liver cirrhosis.5. M2 BPGi can identify hepatitis C-related fibrosis with a moderate sensitivity and specificity and it can be used as a predictor of the liver fibrosis. |
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