Correlation Analysis Between ICG Clearance Test And METAVIR Score Of Liver Tissue In Patients With HBeAg(+)/HBeAg(-) Chronic Hepatitis B

Background:Synthetic function and reserve function of liver are basic indicators for evaluating liver function.The liver reserve function reflects the potential liver parenchymal function,ie,effective hepatocyte reserve.However,Clinical routine indicators of liver function only assess the status of liver anabolic function and the extent of liver damage.Indocyanine green(ICG)clearance test is an ideal indicator for analysis of liver reserve function quantitatively.It has been used for disease assessment and prognosis judgement in severe liver diseases such as liver surgery,cirrhosis,and liver failure routinely.Chronic hepatitis B virus(CHB)is an important public health problem affecting the world.Before the CHB develops to the advanced stage,it will undergo a long period of liver function compensation.The anabolic function of liver remains in the normal range usually,but the liver reserve function may be incomplete at this stage.Therefore,an in-depth understanding of the relationship between changes in liver reserve function and progression of liver disease in patients with CHB has clinical significance for early warning of liver dysfunction and early analysis of clinical outcomes.Objective:A single-center cross-sectional retrospective study was designed to analyze the correlation of ICG clearance test and the METAVIR score of liver tissue in patients with HBeAg(+)/HBeAg(-)CHB to explore the application value of ICG clearance test in judging the progression of CHB liver disease.Methods:407 HBeAg(+)/HBeAg(-)CHB patients with normal or slightly elevated serum ALT were admitted to hospitalized with METAVIR score.Study group:131 CHB patients with METAVIR score<G2S2 were defined as Mild liver disease group(M group);276 CHB patients with METAVIR score>G2&/orS2 were defined as advanced liver disease group(group A).Subgroup classification:HBeAg(+)-M group/HBeAg(+)-A group,HBeAg(-)-M group/HBeAg(-)-A group.The correlation between ICG clearance test and METAVIR scores between each groups was analyzed retrospectively.Statistical analysis of data was performed using SPSS 24.0 softwareResults:1.Clinical basic characteristics of the incorporate patients:(1)Age characteristicsThe average age of HBeAg(+)CHB patients was lower than that of HBeAg(-)CHB patients;(2)Gender characteristics:There was no statistical difference in the distribution ratio of male and female patients of HBeAg(+)CHB and HBeAg(-)CHB,and males were significantly more than females;(3)The proportion of diffuse liver lesions and splenomegaly and MRTAVIR score S>2 in patients with HBeAg(-)CHB was higher than that in patients with HBeAg(+)CHB.However,the baseline mean of white blood cells and platelets were not statistically different between the two groups and were within the normal range;(4)The baseline mean of serum HBsAg titer and serum HBV-DNA load in patients with HBeAg(+)CHB were higher than those in patients with HBeAg(-)CHB.The difference was significant(P=0.000/P=0.000)2.Examination characteristics of ICG-R15 in included patients:(1)The baseline mean of ICG-R15 was not statistically different between the HBeAg(+)CHB and HBeAg(-)CHB groups and was in the normal range basically(ICG-R15<10%);(2)The baseline mean of ICG-R15 was compared between subgroups:The ICG-R15 in subgroup patients with HBeAg(+)-A/HBeAg(-)-A was higher than that in subgroup patients with HBeAg(+)-M/HBeAg(-)-M respectively,and the difference was statistically significant(P=0.013/P=0.000)3.Correlation analysis between ICG-R15 and METAVIR scores in included patients:(1)ICG-R15 were weakly positively correlated with inflammatory activity grade(G)of METAVIR scores in patients with HBeAg(+)/HBeAg(-)CHB(r=0.237,P=0.002/r=0.244,P=0.000);(2)ICG-R15 were weakly positively correlated with fibrosis stage(S)of METAVIR scores in patients with HBeAg(+)/HBeAg(-)CHB(r=0.254,P=0.001/r=0.225,P=0.001)4.Predictive value of ICG-R15 in the progression of liver histology in included patients:(1)When the cutoff value of ICG-RI5 is 5.1%,the area under the ROC curve which based on ICG-R15 for predicting HBeAg(+)/HBeAg(-)CHB patients progress from group M to group A is 0.601(P=0.001);(2)When the cutoff value of ICG-R15 is 4.1%,the area under the ROC curve which based on ICG-R15 for predicting HBeAg(+)CHB patients progress from group M to group A is 0.640(P=0.003);(3)The ROC curve based on ICG-R15 has a limited predictive effect for progressing from group M to group A in patients with HBeAg(-)CHB(P=0.075);When the cutoff value of ICG-R15 is 4.6%,the area under the ROC curve which based on ICG-R15 for predicting METAVIR score G?2 in patients with HBeAg(-)CHB is 0.599(P=0.012);When the cutoff value of ICG-R15 is 4.6%,the area under the ROC curve which based on ICG-R15 for predicting METAVIR score S>2 in patients with HBeAg(-)CHB is 0.591(P=0.015)Conclusion:1.There is a positive correlation between ICG clearance test and METAVIR score of liver tissue in patients with HBeAg(+)/HBeAg(-)CHB who has normal or slightly elevated serum ALT(<2ULN)in this study;2.The cut-off value of ICG-R15 is 10%,in this study,which does not accurately reflect the effective hepatocyte reserve function in patients with HBeAg(+)/HBeAg(-)CHB who has normal or slightly elevated serum ALT(<2ULN);3.In this study,the cut-off value of ICG-R15 is 4.0%?5.0%,which may have value for predicting liver disease progressed to G?2 or S?2 in patients with HBeAg(+)/HBeAg(-)CHB who has normal or slightly elevated serum ALT(<2ULN).