Gamma-glutamyl-transpeptidase to platelet ratio is not superior to APRI,FIB-4 and RPR for diagnosing liver fibrosis in CHB patients in China

Rui Huang,Bei Jia,Jian Wang,Xiaomin Yan,Peixin Song,Yue Yang,Zhenhua Sun,Chao Wu,Yong Liu,Zhaoping Zhang,Yang Li,Guiyang Wang,Juan Xia,Chen Tian,Yali Xiong,Weimao Ding

doi:10.1038/s41598-017-09234-w

Rui Huang, Bei Jia + Show 14 more

Open Access

https://doi.org/10.1038/s41598-017-09234-w

Copy DOI

Journal: Scientific Reports	Publication Date: Aug 17, 2017
Citations: 33	License type: open-access

Affiliation: Nanjing Drum Tower Hospital

Abstract

The gamma-glutamyl transpeptidase to platelet ratio (GPR) is a novel index to estimate liver fibrosis in chronic hepatitis B (CHB). Few studies compared diagnostic accuracy of GPR with other non-invasive fibrosis tests based on blood parameters. We analyzed diagnostic values of GPR for detecting liver fibrosis and compared diagnostic performances of GPR with APRI (aspartate aminotransferase-to-platelet ratio index), FIB-4 (fibrosis index based on the four factors), NLR (neutrophil-to-lymphocyte ratio), AAR (aspartate aminotransferase/alanine aminotransferase ratio) and RPR (red cell distribution width-to-platelet ratio) in HBeAg positive CHB and HBeAg negative CHB. We found AUROCs of GPR in predicting significant liver fibrosis, advanced liver fibrosis and liver cirrhosis were 0.732 (95% CI 0.663 to 0.801), 0.788 (95% CI 0.729 to 0.847) and 0.753 (95% CI 0.692 to 0.814), respectively. Further comparisons showed the diagnostic performance of GPR was not significantly different with APRI, FIB-4 and RPR in identifying significant fibrosis, advanced fibrosis and cirrhosis, but it was significantly superior to AAR and NLR in both HBeAg positive CHB and HBeAg negative CHB. In conclusion, GPR does not show advantages than APRI, FIB-4 and RPR in identifying significant liver fibrosis, advanced liver fibrosis and liver cirrhosis in both HBeAg positive CHB and HBeAg negative CHB in China.

Highlights

IntroductionPatients with chronic hepatitis B virus (HBV) infection have a high risk of progressive liver fibrosis, cirrhosis and even hepatocellular carcinoma (HCC)[1, 2]
Chronic hepatitis B virus (HBV) infection is a major public health problem
Several novel models based on blood or serum parameters such as aspartate transaminase (AST)/alanine aminotransferase (ALT) ratio (AAR), neutrophil-to-lymphocyte ratio (NLR) and red cell distribution width (RDW)-to-platelet ratio (RPR) have been proposed to predict significant fibrosis and cirrhosis over the past decade in chronic hepatitis B (CHB) patients with relatively high accuracy[18]

Summary

Introduction

Patients with chronic HBV infection have a high risk of progressive liver fibrosis, cirrhosis and even hepatocellular carcinoma (HCC)[1, 2]. Liver biopsy (LB) is considered to be the gold standard method to stage the degrees of fibrosis[3] It is restricted the widespread utilization by its invasiveness, patient discomfort, risk of complications, contraindications and sampling error[3,4,5,6]. Several novel models based on blood or serum parameters such as AST/alanine aminotransferase (ALT) ratio (AAR), neutrophil-to-lymphocyte ratio (NLR) and red cell distribution width (RDW)-to-platelet ratio (RPR) have been proposed to predict significant fibrosis and cirrhosis over the past decade in CHB patients with relatively high accuracy[18]. We compared the diagnostic accuracy of GPR with other NITs in both hepatitis B e antigen (HBeAg) positive CHB and HBeAg negative CHB in the present study

Methods

Results

Conclusion