The Value Of GPR Noninvasive Model In Diagnosing Hepatic Fibrosis Of Chronic Hepatitis B

Objective:Clinical data of 312 patients with chronic hepatitis b(CHB)were retrospectively analyzed and summarized to explore the value of the noninvasive model of transglutaminase-platelet ratio(GPR)in diagnosing liver fibrosis in CHB patientsMethods:The case data of 312 CHB patients who had completed liver biopsy in The first affiliated hospital of hunan normal university from January 2017 to October 2019 were retrospectively analyzed and summarized.The collection indicators included patient gender,age,platelet(PLT),transglutaminase(GGT),total bilirubin(TBIL),aspartic acid transferase(AST),and alanine transferase(ALT).The patients were grouped according to the Metavir scoring system-liver fibrosis stage and liver tissue inflammatory activity grade.Noninvasive model values such as GPR,APRI and FIB-4 were calculated to analyze the correlation between GPR,APRI and FIB-4 and liver fibrosis and tissue inflammatory activity in each group.The receiver operating characteristic curve(ROC)was drawn,and the area under the receiver operating characteristic curve(AUC),sensitivity and specificity were calculated.To investigate the diagnostic efficacy of GPR noninvasive model in predicting liver fibrosis in CHB patients and compare it with APRI and FIB-4Results:1.A total of 312 CHB patients were included in this study,including 228 males and 84 females,with an average age of 39.32±12.43 years.GPR,APRI and FIB-4 were not correlated with the age and gender of CHB patients,but were positively correlated with TBIl,AST,ALT and GGT,and negatively correlated with PLT count.The difference was statistically significant(P<0.05)2.GPR,APRI and FIB-4 were positively correlated with the grade of inflammatory activity in liver tissues,with statistically significant differences(P<0.05)3.The correlation coefficients of TBIL,AST,GGT and PLT and liver fibrosis were 0.142,0.197,0.359 and-0.201,respectively(P<0.05),indicating that TBIL,AST and PLT were positively correlated with liver fibrosis,while PLT was negatively correlated with liver fibrosis.The correlation coefficient between ALT and liver fibrosis was 0.069,and the difference was not statistically significant(P>0.05)4.In F0-1 group,the correlation coefficients of GPR,APRI and FIB-4 were 0.098,0.087 and 0.092,respectively.In group F2,the correlation coefficients of GPR,APRI and FIB-4 were 0.342,0.098 and 0.085,respectively.In F3 group,the correlation coefficients of GPR,APRI and FIB-4 were 0.374,0.198 and 0.262,respectively.The correlation coefficients of GPR,APRI and FIB-4 in group F4 were 0.275,0.187 and 0.172,respectively.The difference was statistically significant(P<0.05)5.In F0-1 group,the AUC value of GPR was 0.698,the AUC value of APRI was 0.532,and the AUC value of FIB-4 was 0.561.In group F2,the AUC value of GPR was 0.724,the AUC value of APRI was 0.618,and the AUC value of FIB-4 was 0.632.In the F3 group,the AUC value of GPR was 0.839,the AUC value of APRI was 0.713,and the AUC value of FIB-4 was 0.732.In the F4 group,the AUC value of GPR was 0.843,the AUC value of APRI was 0.799,and the AUC value of FIB-4 was 0.732.6.The optimal truncation values of GPR in F0-1 group,F2 group,F3 group and F4 group were 0.488,0.412,0.512 and 0.531,respectively.Among them,the corresponding sensitivity of F0-1 group was 84.6%and the specificity was 58.3%,the sensitivity of F2 group was 62.3%and the specificity was 87.4%,and the sensitivity of F3 group was 78.1%and the specificity was 90.2%.The sensitivity and specificity of group F4 were 85.4%and 95.4%respectively.7.When GPR was in parallel with APRI(parallel diagnostic experiment),the sensitivity and specificity were F0-1:88.9% and 52.3%,respectively.F2:87.3%,41.2%;F3:84.2%,47.2%;F4:83.3%,56.3%.When GPR was in series with APRI(a series of diagnostic tests),the sensitivity and specificity were F0-1:44.3%and 87.1%,respectively.F2:53.8%,90.3%;F3:42.3%,94.2%;F4:63.4%,97.3%.When GPR was in parallel with FIB-4(parallel diagnostic experiment),the sensitivity and specificity were F0-1:85.2%and 41.7%,respectively.F2:88.4%,57.4%;F3:92.3%,58.5%;F4:94.4%,55.6%.When GPR was in series with FIB-4(a series of diagnostic tests),the sensitivity and specificity were F0-1:41.5%and 86.3%,respectively.F2:64.5%,94.3%;F3:72.4%,98.4%;F4:63.8%,97.4%Conclusion:1.For the diagnosis of chronic hepatitis b fibrosis,when FIB-4,APRI and GPR were applied alone,the AUC value of GPR in groups F2,F3 and F4 was higher than that of FIB-4 and APRI,and the diagnostic efficacy of GPR was higher than that of APRI and FIB-42.The combined detection of GPR and FIB-4 or GPR and APRI can improve the sensitivity and specificity of the diagnosis of CHB liver fibrosis.