Noninvasive Diagnostic Value Of Transient Elastography Combined With APRI And FIB-4 Index On Liver Fibrosis In Patients With Chronic Hepatitis B Virus Infection

Objectives To explore the clinical value of transient elastography combined with aspartame aminotransferase to platelet ratio index(APRI)and fibrosis index based on the 4 factor(FIB-4)on liver fibrosis in patients with chronic hepatitis B virus infection.Methods: The severity of liver fibrosis in 265 chronic hepatitis B virus infection patients was assessed by liver biopsy and liver stiffness measurement(LSM)was checked by Fibro Touch,routine laboratory indicators were examined to calculate APRI and FIB-4 index.The diagnostic value of Fibro Touch,APRI and FIB-4 index in significant fibrosis,advanced fibrosis and cirrhosis were assessed according to the area under the receiver operating characteristic curves(ROC).APRI and FIB-4 index were combined with LSM to evaluate the liver fibrosis degree of patients with chronic hepatitis B respectively and calculated the sensitivity(SN),specificity(SP)et al.Results: 1.With the increase of liver fibrosis,the value of LSM(rs=0.622,P<0.001)had higher correlation than APRI and FIB-4 indexes in liver fibrosis stage.2.Diagnosis of 265 chronic HBV patients,the area under ROC curve of Fibro Touch for significant fibrosis(S?2),advanced fibrosis(S?3)and cirrhosis(S=4)were 0.810,0.881and 0.961 respectively,which were significantly higher than APRI and FIB-4 index.The cutoff value of Fibro Touch,APRI and FIB-4 index in significant fibrosis(S?2),advanced fibrosis(S?3)and cirrhosis(S=4)were obtained according to the area under the ROC cure,the sensitivity and specificity of Fibro Touch on any hepatic fibrosis stage are all better than APRI and FIB-4.3.Fibro Touch combined with APRI or FIB-4 indexes respectively.parallel test improved the sensitivity of diagnosis.The value of sensitivitywas more than 91.11% when Fibro Touch combined with APRI by theparallel test respectively and the sensitivity also increased obviously when combined with FIB-4.However,the specificity of diagnosis had a significant improvement by serial test.The value of specificity was more than 94.42% when Fibro Touch was combined with APRI by the serial test respectively.Conclusions The sensitivity and specificity of Fibro Touch on diagnosis of hepatic fibrosis are all better than APRI and FIB-4.In the noninvasive diagnosis of liver fibrosis,each of their combinations is better than that of the individual.