| Objective: This paper applies ROC curve to evaluate the diagnostic effect of four serological indicators for liver fibrosis in patients with chronic hepatitis B,and explores its clinical significance.Methods: 118 cases of patients with chronic hepatitis B in our hospital from Ap ril 2015 to November 2016 were selected,100 of them with gallstone were perf ormed cholecystectomy and 18 of them with portal hypertension were performed splenectomy.All patients had intraoperative liver biopsy and were divided into different stages according to the Metavir liver fibrosis scoring system.In addition,the laboratory data of HA,IV-C,MAO,TGF-?1 on the day before operation w ere collected to analyze the correlation between the four indicators and the stage of liver fibrosis,and the ROC curve was established to evaluate the value of i ndividual diagnosis and combined diagnosis of four serological indicators of liver fibrosis in patients with chronic hepatitis B.Results: 118 surgeries were all completed successfully without any deaths during or after the surgeries.Intraoperative liver biopsy results showed that there were 25 cases in F0,20 in F1,19 in F2,23 in F3 and 31 in F4.The stages of liver fibrosis were positively correlated to the inflammation degrees(the value of correlation coefficient was 0.657,p=0.000).The analysis of preoperative HA?IV-C?MAO?TGF-?1 levels in patients with different liver fibrosis stages showed that the HA level of patients in F0~F4 stages were(70.81±37.73)ng/ml,(91.62±39.08)ng/ml,(70±36.22)ng/ml,(91.98±40.88)ng/ml,(111.85±49.27)ng/ml;the IV-C level of patients in F0~F4 stages were(68.60±35.30)ng/ml,(85.32±41.81)ng/ml,(103.82±43.76)ng/ml(102.83±54.39)ng/ml,(133.53±60.92)ng/ml;the MAO level of patients in F0~F4 stages were respectively(12.79±6.44)U/L,(15.42±6.56)U/L,(18.54±7.15)U/L,(17.62±8.92)U/L,(25.50±8.37)U/L;the TGF-?1level of patients in F0~F4 stages were(12.79±6.44)ng/ml,(15.42±6.56)ng/ml,(18.54±7.15)ng/ml,(17.62±8.92)ng/ml,(25.50±8.37)ng/ml.The Speraman correlation analysis of the four serological indicators and liver fibrosis stages manifested that the levels of HA?IV-C?MAO?TGF-?1 were positively correlated with liver fibrosis stages(p<0.05).By using 1-specificity as X axis and sensitivity as Y axis to draw the ROC curve,the result showed that the AUC of HA?IV-C?MAO?TGF-?1 in diagnosis of significant liver fibrosis were 0.64?0.72?0.76?0.80 and when combining the four indicators,the AUC reached to 0.83,and the AUC of HA?IV-C?MAO?TGF-?1in diagnosis of cirrhosis were 0.69?0.73?0.82?0.80 and when combining the four indicators,the AUC reached to 0.83.Conclusion: 1.All the four indicators showed a good correlation with the liver fibrosis stages in patients with chronic hepatitis B and TGF-?1 had the highest correlation.The diagnostic performance of TGF-?1 were the best in apparent liver fibrosis group(F?2),the diagnostic performance of MAO were the best in cirrhosis group(F=4).2.The method of combining the four indicators had a higher diagnostic value than using single indicator which can be recommended as a simple,noninvasive and efficient diagnostic method for the liver fibrosis in patients with chronic hepatitis B. |
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