Noninvasive models to predict liver cirrhosis in patients with chronic hepatitis B

Liver Int. 2007 Sep;27(7):969-76. doi: 10.1111/j.1478-3231.2007.01519.x.

Abstract

Objectives: Few noninvasive models of chronic hepatitis B (CHB) to predict liver cirrhosis have been studied. The aim of the current study is to investigate the diagnostic accuracy of two simple novel models of spleen-platelet ratio index (SPRI) and age-spleen-platelet ratio index (ASPRI) in patients with CHB.

Patients and methods: A total of 346 consecutive treatment-naïve patients with CHB were retrospectively studied. The aspartate to alanine aminotransferase ratio (AAR), age-platelet index (API), aspartate aminotransferase to platelet ratio index (APRI), SPRI, and ASPRI were compared with liver histology.

Results: AAR, APRI, SPRI, API, and ASPRI correlated significantly to fibrosis stage (all P<0.001). The diagnostic accuracy of ASPRI was the highest among five tests for prediction of cirrhosis (area under receiver operating characteristic curve, AUROC=0.893). Using a cutoff score of ASPRI>12, the presence of cirrhosis could be correctly identified with a high accuracy (96.3% positive predictive value) in 35 (10.1%) of 346 patients. Similarly, using a cutoff of <5, the presence of cirrhosis could be totally excluded with 100% of negative predictive value in 120 (34.7%) of 346 patients.

Conclusion: ASPRI was accurate in predicting cirrhosis and screening with ASPRI has the potential to reduce the number of liver biopsies in CHB patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Alanine Transaminase / blood*
  • Aspartate Aminotransferases / blood*
  • Biopsy
  • Clinical Enzyme Tests*
  • Disease Progression
  • Female
  • Hepatitis B, Chronic / blood
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / pathology
  • Humans
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / virology
  • Logistic Models
  • Male
  • Middle Aged
  • Models, Biological*
  • Platelet Count
  • Predictive Value of Tests
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Severity of Illness Index
  • Spleen / pathology*

Substances

  • Aspartate Aminotransferases
  • Alanine Transaminase