Fibrotouch Combined With FIB-4, APRI And GPRI In Diagnosis Of Liver Fibrosis

Objective: To explore the value of the combination of FibroTouch,fibrosis index based on the 4 factor(FIB-4),AST-to-PLT ratio index(APRI)and GGT-to-PLT ratio index(GPRI)in diagnosis of liver fibrosis in patients with chronic liver disease.Methods: A total of 337 patients with chronic liver disease were selected and performed liver biopsy in Department of Traditional and Western Medical Hepatology,Third Hospital of Hebei Medical University from January 2014 to April 2017.The GPRI,APRI,FIB-4 were calculated and liver stiffness was measured by FibroTouch.The diagnostic values of FibroTouch,GPRI,APRI and FIB-4 for liver fibrosis degree were compared by receiver operating characteristic(ROC)curves,and area under ROC curves(AUROCs)were used to analyze the results of the models.The correlation between LSM,APRI,GPRI,FIB-4 and clinical characteristics were analyzed according to Spearman analysis.Posterior probability was calculated to explore the accuracy of combining four methods in diagnosis of liver fibrosis.Results:1.Hepatic histopathological results: The patients were divided into significant liver fibrosis group(a liver fibrosis stage of ≥S2,n=169),advanced liver fibrosis group(a liver fibrosis stage of ≥S3,n=86),liver cirrhosis group(a liver fibrosis stage of =S4,n=42).2.The diagnostic efficacy of FibroTouch,FIB-4,APRI and GPRI: The AUROCs of the LSM for predicting significant liver fibrosis,advanced liver fibrosis and liver cirrhosis were 0.826,0.882,0.920,which were significantly higher than FIB-4(0.734,0.711,0.739),APRI(0.662,0.669,0.719)and GPRI(0.621,0.674,0.720).3.The influence factors of FibroTouch,FIB-4,APRI and GPRI and correlation of them: LSM was correlated with histopathological fibrosis(r=0.564 P<0.001)and inflammation grade(r=0.651,P<0.001).4.The diagnostic efficacy of FibroTouch combined with FIB-4,APRI and GPRI: The probability of LSM in diagnosing liver fibrosis of S≥2,S≥3 and S=4 was 72.44%,80.52%,84.21%.When FIB-4,APRI and GPRI were combined with LSM in diagnosing liver fibrosis of S≥2,S≥3 and S=4,the posterior probability was 95.71%,98.6%,99.08%.Conclusions: A combination of FibroTouch and FIB-4 can improve the accuracy of diagnosing liver fibrosis,and the demand of liver biopsy will dicrease significantly when combined with APRI and GPRI further,which is beneficial to confirming timely,monitoring dynamically and treating effectively.