The Value Of APRI And FIB-4 In Diagnosis Of Fibrosis In Chronic HBV Carriers

Objective: To evaluate the performance of aspartate transaminase-to-platelet ratio index(APRI)and fibrosis index based on four factors(FIB-4)to predict significant fibrosis and cirrhosis in the chronic HBV carriers.Methods: A retrospective study was conducted to collect 209 patients who were diagnosed as chronic HBV carriers and 154 patients who were diagnosed as chronic HBV carriers I,hospitalizing from June 2010 to June 2018 in the First Affiliated Hospital of Fujian Medical University liver disease center,MengChao Hepatobiliary Hospital of Fujian Medical University,First Hospital Infection Department of QuanZhou City,The Affiliated Hospital of PuTian University.And collect the baseline data of the patients(age,gender,)and the clinical data,including: five indicator test for Hepatitis B,HBV DNA,routine blood test,and four coagulation tests,biochemical,liver fibrosis stages.The Spearman correlation analyzed the relationship between APRI?FIB-4 and liver fibrosis of the chronic HBV carriers and chronic HBV carriers I.A noninvasive model was set up through multivariate logistic regression analysis.The ROC curve was used to evaluate the diagnostic value of the model and the Z test was adopted.The outcome was less than 0.05 showing a significant difference.All statistical analyses were carried out using the SPSS statistical software version 22.0 and MedCalc Statistical Software version 15.0.Results: 1.APRI and FIB-4 were positively correlated with fibrosis stage of chronic HBV carrier group(r=0.288,P<0.001;r=0.238,P<0.001).APRI and FIB-4 were positively correlated with fibrosis stage of chronic HBV carrier ?(r=0.337,P<0.001;r=0.282,P<0.001).2.The AUC of APRI and FIB-4 were(0.685 vs 0.643;P=0.137)for diagnosing significant fibrosis in chronic HBV carriers;the AUC of APRI and FIB-4 were(0.749 vs 0.691;P=0.252)for diagnosing cirrhosis in chronic HBV carriers.3.When the cut-off values proposed by WHO HBV guideline for APRI(>1.5 and >2.0)was used,patients with significant fibrosis and cirrhosis were not correctly predicted.Similarly,for FIB-4,the WHO proposed cut-off value of 3.5,patients with significant fibrosis were also not correctly predicted.Except the significant fibrosis,only 54 percent of the insignificant fibrosis patients were found when APRI was less than 0.5,and the FIB-4 cut-off of 1.45 correctly identified 56 percent of the insignificant fibrosis patients.4.Based on ROC analysis,the AUC of APRI for predicting significant fibrosis and cirrhosis in chronic HBV carriers were 0.685 and 0.749,then the optimal cut-off values of these were 0.31 and 0.39 respectively;The AUC of FIB-4 for predicting significant fibrosis and cirrhosis in chronic HBV carriers were 0.643 and 0.691,then the optimal cut-off values of these were 0.89 and 1.08 respectively.5.The AUC of APRI were 0.642 and 0.706 for predicting significant fibrosis and cirrhosis in chronic HBV carriers ?;The AUC of FIB-4 were 0.618 and 0.645 for predicting significant fibrosis and cirrhosis in chronic HBV carriers ?.6.In the total sample,the AUC of YGP were 0.730 and 0.824 for the diagnosis of significant fibrosis and severe liver fibrosis in chronic HBV carriers.The AUC of YGP and APRI were 0.730 and 0.685(Z=1.513,P=0.130)for diagnosing significant fibrosis in chronic HBV carriers,and the AUC of YGP and FIB-4 were 0.730 and 0.643(Z=2.263,P=0.024).The AUC of YGP and APRI were 0.824 vs 0.806(Z=0.44,P=0.66)for diagnosing Severe fibrosis in chronic HBV carriers,and the AUC of YGP and FIB-4 were 0.824 vs 0.742(Z=1.64,P=0.10).7.The AUC of YGP and YGP2 were 0.749 vs 0.760(Z=0.70,P=0.48)for diagnosing significant fibrosis in chronic HBV carriers I,and the AUC of YGP and YGP2 were 0.856 vs 0.880(Z=1.18,P=0.24).Conclusion: 1.The WHO HBV guidelines recommend that the APRI and FIB-4 thresholds are not suitable for assessing liver fibrosis in chronic HBV carriers.2.To diagnose significant liver fibrosis and cirrhosis in chronic HBV carriers,the APRI optimal cutoff values were 0.31 and 0.39;the FIB-4 optimal cutoff values were 0.89 and 1.08.3.The YGP model is more suitable for assessing significant liver fibrosis in chronic HBV carriers;4.The new model of YGP can also be used to predict chronic HBV carriers I.In practice,the accurate indicators of liver fibrosis should be used.