Abstract
Background and aim: Non- invasive parameters of liver fibrosis are being widely incorporated and adopted in clinical practice, of them, 2 ratios APRI and FIB-4 were proposed and applied. The gamma-glutamyl transferase -to- platelet ratio (GPR) was developed and investigated as available test that is useful in predicting liver fibrosis stages in chronic HBV patients. We aimed to estimate the diagnostic performance of GPR compared to APRI in assessing different fibrosis stages estimated by ultrasound based Transient Elastography in chronic HCV Egyptian patients. Methods: This prospective study was conducted on 90 treatment-naive chronic HCV patients. Fibrosis stages were assessed by Transient Elastography. Serum aspartate transferase, alanine transferase, gamma-glutamyl transferase and platelets were estimated. APRI and GPR formulas were calculated. Results: GPR was significantly different with fibrosis stage (p value F3) from non-significant fibrosis (< F3) was significant with GPR AUC was 0.97 while APRI AUC was 0.86. GPR at cutoff point 0.31 has sensitivity 92 %, specificity 88%, PPV 86 % and NPV 91 %. While, APRI at cutoff 0.26 has sensitivity 81 % and specificity 78 %. Conclusion: The GPR represents a simple, non-invasive, inexpensive model for assessment of liver fibrosis. The GPR is a more accurate model than APRI to stage liver fibrosis in chronic HCV patients in Egypt.
Highlights
Chronic liver injury whatever the etiology leads to liver fibrosis. which results in structural and functional hepatic changes with extracellular matrix accumulation in diffuse pattern due to disturbed balance in their production, deposition, and degradation of fibrosis [1,2].Different stages of fibrosis are important issues for diagnosis, follow up and treatment in patients with chronic liver disease
The fibrosis stages measured by Fibroscan were distributed as follow, F0 in 18 patients (20%), F0-F1 in 4 cases (4.4%), F1-F2 in 10 patients (11.1%), F2 in 2 patients (2.2%), F3 in 9 cases (10%), F3-4 in 7 patients (7.8%) and F4 was present in 26 patients (28.9%)
We found that mean ± SD of different stages of fibrosis was statistically varied with different age groups (p value was
Summary
Different stages of fibrosis are important issues for diagnosis, follow up and treatment in patients with chronic liver disease. Liver biopsy is considered the gold standard in assessment of liver fibrosis in addition to diagnosis of some conditions but its drawbacks as invasive procedure limit its use as well as sampling variations and patient’s preference [7, 8, 9]. The gamma-glutamyl transferase -toplatelet ratio (GPR) was developed and investigated as available test that is useful in predicting liver fibrosis stages in chronic HBV patients. We aimed to estimate the diagnostic performance of GPR compared to APRI in assessing different fibrosis stages estimated by ultrasound based Transient Elastography in chronic HCV Egyptian patients
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