Gastroenterology Department, Gülhane Education and Training Hospital, Ankara, Turkey.
Gastroenterology Department, TOBB University of Economics and Technology, Ankara, Turkey.
Medicine (Baltimore). 2022 Sep 9;101(36):e30488. doi: 10.1097/MD.0000000000030488.
Liver fibrosis is the most important factor in the prognosis and treatment plan of patients with chronic hepatitis B (CHB). Aspartate aminotransferase (AST)-to-platelet ratio index (APRI), fibrosis index based on 4 factors (FIB-4), and fibrosis index based on 5 factors (FIB-5) scores are noninvasive fibrosis markers, and previous comparative studies have shown that they are as effective as liver biopsy in detecting liver fibrosis in different liver diseases. The aim of our study is to investigate whether existing scoring systems are effective in demonstrating fibrosis in CHB patients and to compare the APRI, FIB 4, and FIB 5 scores in differentiating early and advanced fibrosis in 123 patients who underwent liver biopsy for CHB infection. APRI, FIB-4, and FIB-5 scores of patients who underwent liver biopsy due to CHB were calculated by means of calculators and recorded to be compared with liver biopsies in terms of fibrosis scoring. One hundred twenty-three patients who underwent liver biopsy due to chronic hepatitis B were included in the study. APRI (area under the receiver-operating characteristic [ROC] curve 0.728), FIB-4 (area under the ROC curve 0.693) and FIB-5 (area under the ROC curve 0.643) scores were evaluated as significant predictors of advanced fibrosis. The scoring system with the highest positive and negative predictive value was evaluated as FIB-4. APRI, FIB-4, and FIB-5 scoring systems are appropriate scoring systems in the assessment of advanced fibrosis in patients with CHB. Our study is the first to compare APRI, FIB-4, and FIB-5 values in CHB patients, and more comprehensive studies are needed.
肝纤维化是慢性乙型肝炎（CHB）患者预后和治疗方案的最重要因素。天门冬氨酸氨基转移酶（AST）-血小板比值指数（APRI）、基于 4 项因素的纤维化指数（FIB-4）和基于 5 项因素的纤维化指数（FIB-5）评分是非侵入性纤维化标志物，先前的比较研究表明，它们在不同肝病中检测肝纤维化的效果与肝活检相当。我们的研究旨在探讨现有的评分系统是否能有效地显示 CHB 患者的纤维化，并比较 APRI、FIB-4 和 FIB-5 评分在区分 123 例因 CHB 感染而行肝活检的患者的早期和晚期纤维化中的作用。通过计算器计算并记录因 CHB 而行肝活检的患者的 APRI、FIB-4 和 FIB-5 评分，与肝活检的纤维化评分进行比较。本研究纳入了 123 例因慢性乙型肝炎而行肝活检的患者。APRI（ROC 曲线下面积 0.728）、FIB-4（ROC 曲线下面积 0.693）和 FIB-5（ROC 曲线下面积 0.643）评分被评估为晚期纤维化的显著预测因子。评分系统具有最高的阳性和阴性预测值，被评估为 FIB-4。APRI、FIB-4 和 FIB-5 评分系统是评估 CHB 患者晚期纤维化的合适评分系统。我们的研究首次比较了 CHB 患者的 APRI、FIB-4 和 FIB-5 值，需要进行更全面的研究。
