Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2022; 28(27): 3503-3513
Published online Jul 21, 2022. doi: 10.3748/wjg.v28.i27.3503
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:
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.
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
Research background

Patients infected with hepatitis B virus (HBV) tend to develop liver fibrosis and liver cirrhosis. Those with cirrhosis have a high risk of hepatic decompensation and hepatitis B- related hepatocellular carcinoma.

Research motivation

Liver biopsy was used to ascertain the degree of fibrosis/cirrhosis. However, as an invasive procedure, liver biopsy has many disadvantages. The Guidelines Development Group recommended the use of noninvasive tests to assist in the assessment of liver disease stage and the diagnosis of fibrosis/cirrhosis. The use of a noninvasive test can reduce the need for liver biopsy.

Research objectives

The present study aimed to develop a precise noninvasive test to stage liver fibrosis/cirrhosis and compare the diagnostic values between different noninvasive methods.

Research methods

Univariable logistic regression was used to identify significant predictive factors. Correlation analysis was performed to reveal the correlation between clinical parameters and liver stage. Receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic accuracy of different noninvasive methods.

Research results

The presence of liver fibrosis was significantly related to alkaline phosphatase and the gamma-glutamyl transpeptidase to platelet ratio (AGPR). There was a significant positive correlation between AGPR and liver fibrosis stage. The area under the ROC curve values of AGPR were 0.83, 0.84, and 0.87 for the prediction of significant fibrosis, extensive fibrosis, and cirrhosis, respectively. The AGPR index had a better overall performance than other noninvasive indices.

Research conclusions

AGPR can be used to detect the presence of significant fibrosis, extensive fibrosis, and cirrhosis with high diagnostic accuracy, sensitivity, and specificity in patients with chronic HBV infection.

Research perspectives

The AGPR index is a promising noninvasive marker for assessing liver disease stage. The use of AGPR can help with the routine monitoring of hepatic fibrosis and cirrhosis.