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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Novel index for the prediction of significant liver fibrosis and cirrhosis in chronic hepatitis B patients in China
Min-Jun Liao, Jun Li, Wei Dang, Dong-Bo Chen, Wan-Ying Qin, Pu Chen, Bi-Geng Zhao, Li-Ying Ren, Ting-Feng Xu, Hong-Song Chen, Wei-Jia Liao
Min-Jun Liao, Jun Li, Wei Dang, Wan-Ying Qin, Bi-Geng Zhao, Li-Ying Ren, Ting-Feng Xu, Wei-Jia Liao, Laboratory of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi Zhuang Autonomous Region, China
Min-Jun Liao, Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Jun Li, Genetics and Precision Medicine Laboratory, The Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi Zhuang Autonomous Region, China
Dong-Bo Chen, Pu Chen, Hong-Song Chen, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Disease, Peking University People’s Hospital, Beijing 100044, China
Author contributions: Liao MJ, Li J, and Dang W contributed equally to this work; Liao WJ was the guarantor and designed the study; Liao MJ, Li J, Chen DB, Qin WY, Chen P, Zhao BG, Ren LY, Xu TF, and Liao WJ participated in the acquisition, analysis, and interpretation of the data; Li J and Dang W drafted the initial manuscript; Chen HS and Liao WJ revised the article critically for important intellectual content.
Supported by the National Natural Science Foundation of China, No. 81372163; the Natural Science Foundation of Guangxi, No. 2018GXNSFDA138001; the Science and Technology Planning Project of Guilin, No. 20190218-1; the Opening Project of Key laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, No. GKE-KF202101; and the Program of Guangxi Zhuang Autonomous Region Health and Family Planning Commission, No. Z20210706 and No. Z20190665.
Institutional review board statement: The study was reviewed and approved by the research ethics committee of Affiliated Hospital of Guilin Medical University.
Informed consent statement: Informed consent was obtained from all patients.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Wei-Jia Liao, MD, Chief Doctor, Professor, Laboratory of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Guilin Medical University, No. 15 Lequn Road, Xiufeng District, Guilin 541001, Guangxi Zhuang Autonomous Region, China.
liaoweijia288@163.com
Received: February 14, 2022
Peer-review started: February 14, 2022
First decision: March 9, 2022
Revised: March 23, 2022
Accepted: June 18, 2022
Article in press: June 18, 2022
Published online: July 21, 2022
Processing time: 153 Days and 21 Hours
BACKGROUND
Noninvasive, practical, and convenient means of detection for the prediction of liver fibrosis and cirrhosis in China are greatly needed.
AIM
To develop a precise noninvasive test to stage liver fibrosis and cirrhosis.
METHODS
With liver biopsy as the gold standard, we established a new index, [alkaline phosphatase (U/L) + gamma-glutamyl transpeptidase (U/L)/platelet (109/L) (AGPR)], to predict liver fibrosis and cirrhosis. In addition, we compared the area under the receiver operating characteristic curve (AUROC) of AGPR, gamma-glutamyl transpeptidase to platelet ratio, aspartate transaminase to platelet ratio index, and FIB-4 and evaluated the accuracy of these routine laboratory indices in predicting liver fibrosis and cirrhosis.
RESULTS
Correlation analysis revealed a significant positive correlation between AGPR and liver fibrosis stage (P < 0.001). In the training cohort, the AUROC of AGPR was 0.83 (95%CI: 0.78-0.87) for predicting fibrosis (≥ F2), 0.84 (95%CI: 0.79-0.88) for predicting extensive fibrosis (≥ F3), and 0.87 (95%CI: 0.83-0.91) for predicting cirrhosis (F4). In the validation cohort, the AUROCs of AGPR to predict ≥ F2, ≥ F3 and F4 were 0.83 (95%CI: 0.77-0.88), 0.83 (95%CI: 0.77-0.89), and 0.84 (95%CI: 0.78-0.89), respectively.
CONCLUSION
The AGPR index should become a new, simple, accurate, and noninvasive marker to predict liver fibrosis and cirrhosis in chronic hepatitis B patients.
Core Tip: Chronic hepatitis B virus (HBV) infection is highly endemic in China, and routine assessment of chronic hepatitis B patients is greatly needed to guide management and indicate the need for treatment. In this study, we established a new index to stage liver fibrosis and cirrhosis in patients with chronic HBV infection in China. In addition, the study compared the predictive performance between the new index and other noninvasive indices. The new index is suitable for regular monitoring and is crucial for the management of patients with liver fibrosis/cirrhosis.
