Development and validation of a novel score for fibrosis staging in patients with chronic hepatitis B. (19th May 2018)

• Record Type: Journal Article
• Authors: Wu, Daxian; Rao, Qunfang; Chen, Wenqian; Ji, Feiyang; Xie, Zhongyang; Huang, Kaizhou; Chen, Er'mei; Zhao, Yalei; Ouyang, Xiaoxi; Zhang, Sainan; Jiang, Zhengyi; Zhang, Lingjian; Xu, Linjie; Gao, Hainv; Li, Lanjuan
• Is Part Of: Liver international. Volume 38:Number 11(2018)
• Page Start: 1930
• Page End: 1939
• Publication Date: 2018-05-19
• Subjects: chronic hepatitis B -- free tetraiodothyronine -- liver biopsy -- liver fibrosis; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.13756
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: Background & Aims: Non‐invasive assessment methods for liver fibrosis are urgently needed. The present study aimed to develop a novel diagnostic model for fibrosis staging in patients with chronic hepatitis B. Methods: A cross‐sectional set of 417 chronic hepatitis B patients who underwent liver biopsy was enrolled and the METAVIR score was adopted as the reference of fibrosis staging. Results: Among thyroid hormones, only the level of free tetraiodothyronine (FT4) decreased gradually with the METAVIR fibrosis score ( P < .001). FibroStage, a novel diagnosis model that incorporates data on FT4, platelets, cholinesterase, gamma‐glutamyl transpeptidase, and age, was developed using the deriving set (n = 219). For the diagnosis of significant fibrosis, the FibroStage model had a significantly higher area under the receiver operating curve than did the FibroIndex, Forn, and Lok models (all of P < .01) and tended to better than the fibrosis‐4 ( P = .0791) but comparable with the aspartate transaminase‐to‐platelet ratio index model ( P = .1694). For the diagnosis of advanced fibrosis, FibroStage had a higher area under the receiver operating curve than did the aspartate transaminase‐to‐platelet ratio index, FibroIndex, Forn, and Lok models (all of P < .05) and had a comparable area under the receiver operating curve with the fibrosis‐4 model ( P = .2109). For the diagnosis of cirrhosis, the area under the receiver operating curve of FibroStage was higher than those of the aspartate transaminase‐to‐platelet ratio index, fibrosis‐4, FibroIndex, and Lok (all of P < .05) models and was comparable with Forn ( P = .1649). These results was validated by a validation set (n = 198). Conclusion: FT4 may be an indicator for fibrosis staging in chronic hepatitis B patients. FibroStage is a better model than aspartate transaminase‐to‐platelet ratio index, fibrosis‐4, FibroIndex, Forn, and Lok for the comprehensively diagnosis of significant and advanced fibrosis and cirrhosis.