Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
J Viral Hepat. 2020 Jun;27(6):602-609. doi: 10.1111/jvh.13264. Epub 2020 Feb 8.
Noninvasive tests (NITs) for liver fibrosis are highly needed for chronic hepatitis B (CHB) patients. We aimed to investigate whether plateletcrit (PCT) could be used as a NIT in predicting liver fibrosis for CHB patients. Five hundred and sixty-seven treatment-naïve CHB patients with available liver biopsies were included. Patients were randomly divided into a derivation cohort (n = 378) and a validation cohort (n = 189). The diagnostic accuracy of PCT was evaluated using receiver operating characteristic (ROC) curves. In the derivation cohort, PCT in CHB patients with S2-S4 (0.14%), S3-S4 (0.13%) and S4 (0.12%) was lower than patients with S0-S1 (0.17%, P < .001), S0-S2 (0.17%, P < .001) and S0-S3 (0.16%, P < .001), respectively. PCT was an independent predictor of significant fibrosis (≥S2), advanced fibrosis (≥S3) and cirrhosis (S4). The area under the ROC curve (AUROC) of PCT in predicting significant fibrosis, advanced fibrosis and cirrhosis was 0.645, 0.709 and 0.714, respectively. The AUROC of PCT was higher than the aspartate transaminase to platelet ratio index (APRI) in identifying advanced fibrosis and cirrhosis, while this was comparable with APRI in identifying significant fibrosis. The diagnostic value of PCT was comparable with fibrosis-4 score (FIB-4) in predicting significant fibrosis, advanced fibrosis and cirrhosis. In the validation cohort, PCT could also identify significant fibrosis, advanced fibrosis and cirrhosis with similar diagnostic accuracy as in the derivation cohort. PCT represents a simple and inexpensive indictor for liver fibrosis in CHB patients. PCT is just as good or better than other more complex tools for staging liver fibrosis in CHB patients.
对于慢性乙型肝炎 (CHB) 患者，非常需要非侵入性肝纤维化检测 (NIT)。我们旨在研究血小板压积 (PCT) 是否可作为 CHB 患者预测肝纤维化的 NIT。纳入了 567 名有可用肝活检的初治 CHB 患者。患者被随机分为推导队列 (n=378) 和验证队列 (n=189)。使用受试者工作特征 (ROC) 曲线评估 PCT 的诊断准确性。在推导队列中，S2-S4 (0.14%)、S3-S4 (0.13%)和 S4 (0.12%)的 CHB 患者的 PCT 低于 S0-S1 (0.17%，P<.001)、S0-S2 (0.17%，P<.001)和 S0-S3 (0.16%，P<.001)的患者。PCT 是显著纤维化 (≥S2)、进展性纤维化 (≥S3)和肝硬化 (S4)的独立预测因子。PCT 预测显著纤维化、进展性纤维化和肝硬化的 ROC 曲线下面积 (AUROC) 分别为 0.645、0.709 和 0.714。PCT 的 AUROC 高于天冬氨酸转氨酶与血小板比值指数 (APRI) 识别进展性纤维化和肝硬化，而在识别显著纤维化方面，与 APRI 相当。PCT 的诊断价值与纤维化-4 评分 (FIB-4) 相当，可预测显著纤维化、进展性纤维化和肝硬化。在验证队列中，PCT 也可以识别出与推导队列中相似的显著纤维化、进展性纤维化和肝硬化，具有相似的诊断准确性。PCT 是 CHB 患者肝纤维化的一种简单且经济的指标。PCT 与其他更复杂的工具一样，或优于其他更复杂的工具，可用于 CHB 患者的肝纤维化分期。
