First Department of Internal Medicine, Medical School of National & Kapodistrian University, General Hospital of Athens "Laiko" , Athens , Greece.
Expert Rev Gastroenterol Hepatol. 2019 Sep;13(9):877-891. doi: 10.1080/17474124.2019.1653757. Epub 2019 Aug 12.
: Red cell distribution width to platelet ratio (RPR) may be a useful marker for the evaluation of liver fibrosis in chronic liver disease (CLD). We sought to investigate its value in fibrosis-related outcomes in a meta-analysis of diagnostic accuracy. : We searched MEDLINE (1966-2019), Clinicaltrials.gov (2008-2019), Cochrane Central Register of Controlled Trials (CENTRAL) (1999-2019), Google Scholar (2004-2019) and WHO (International Clinical Trials Register Platform) databases using a structured algorithm. The articles were assessed by Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2). In over 1,800 patients for each outcome, pooled sensitivity and specificity for a) significant fibrosis, b) advanced fibrosis and c) cirrhosis were: a) 0.635 and 0.769 with an AUC of 0.747, b) 0.607 and 0.783 with an AUC of 0.773, c) 0.739 and 0.768 with an AUC of 0.818 respectively. Similar results were found for chronic hepatitis B in all outcomes. Subgroup analysis indicated a high specificity for advanced fibrosis detection in primary biliary cirrhosis. Sensitivity analysis did not alter the results. : RPR is a good predictor of fibrosis, especially as severity of chronic liver disease progresses. Future research should elucidate its value in specific etiologies of chronic liver disease.
红细胞分布宽度与血小板比值（RPR）可能是评估慢性肝病（CLD）肝纤维化的有用标志物。我们旨在通过诊断准确性的荟萃分析研究其在纤维化相关结局中的价值。
我们使用结构化算法检索了 MEDLINE（1966-2019 年）、Clinicaltrials.gov（2008-2019 年）、Cochrane 中央对照试验注册中心（CENTRAL）（1999-2019 年）、Google Scholar（2004-2019 年）和世界卫生组织（国际临床试验注册平台）数据库。使用质量评估诊断准确性研究工具（QUADAS-2）评估文章。在每个结局中，超过 1800 名患者的汇总敏感性和特异性为：a）显著纤维化，b）进展性纤维化和 c）肝硬化分别为：a）0.635 和 0.769，AUC 为 0.747，b）0.607 和 0.783，AUC 为 0.773，c）0.739 和 0.768，AUC 为 0.818。在所有结局中，慢性乙型肝炎也有类似的结果。亚组分析表明，原发性胆汁性肝硬化中进展性纤维化检测的特异性较高。敏感性分析没有改变结果。
RPR 是纤维化的良好预测指标，尤其是随着慢性肝病严重程度的进展。未来的研究应该阐明其在慢性肝病特定病因中的价值。
