Li Yan, Zhang Meng-Jun, Wang Xue-Hong, Li Su-Hua
Department of Gastroenterology, The Affiliated Hospital of Qinghai University, Xining, Qinghai 810001, P.R. China.
Biomed Rep. 2023 Nov 13;20(1):1. doi: 10.3892/br.2023.1689. eCollection 2024 Jan.
The present study aimed to investigate the accuracy of new noninvasive markers in predicting liver fibrosis among individuals with primary biliary cholangitis (PBC). This retrospective analysis included subjects with PBC who had liver biopsies. Scheuer's classification was used to determine the fibrosis stage. The bilirubin to albumin (Alb) ratio (BAR), fibrosis index based on the four factors (FIB-4), γ-glutamyl transpeptidase to platelet (PLT) ratio (GPR), red cell distribution width to PLT ratio (RPR), aspartate aminotransferase (AST) to alanine aminotransferase ratio (AAR), AST to PLT ratio index (APRI) and total bilirubin to PLT ratio (TPR) were calculated based on the laboratory parameters. A novel index called BARP was conceived as BAR x RPR. A total of 78 individuals with PBC were included in the study, 84.6% of whom had significant fibrosis, 30.8% had advanced fibrosis and 15.4% had cirrhosis. In the multivariate analysis, Alb was determined to be an independent predictor of advanced fibrosis (odds ratio=0.823, P=0.034). The area under the receiver operating characteristic curves (AUROCs) of the BAR, GPR, TPR and BARP were statistically significant in predicting severe fibrosis (P<0.05) and were 0.747, 0.684, 0.693 and 0.696, respectively. In assessing advanced fibrosis, the AUROCs for the AAR, APRI, BAR, FIB-4, RPR, TPR and BARP were 0.726, 0.650, 0.742, 0.716, 0.670, 0.735 and 0.750, respectively. The AUROCs for the APRI, BAR, FIB-4, RPR, TPR and BARP for cirrhosis prediction were 0.776, 0.753, 0.821, 0.819, 0.808 and 0.832, respectively. By comparing the AUROCs, it was demonstrated that the diagnostic capabilities of the BARP (P=0.021) and TPR (P=0.044) were superior to those of the APRI in predicting advanced fibrosis. In conclusion, the BAR, BARP and TPR were of predictive value for the grade of liver fibrosis in PBC and Alb had a diagnostic value in identifying early fibrosis. The aforementioned noninvasive indices may be used for predicting histologic stages of PBC.
本研究旨在调查新型非侵入性标志物在预测原发性胆汁性胆管炎（PBC）患者肝纤维化方面的准确性。这项回顾性分析纳入了接受肝活检的PBC患者。采用Scheuer分类法确定纤维化阶段。根据实验室参数计算胆红素与白蛋白（Alb）比值（BAR）、基于四项因子的纤维化指数（FIB-4）、γ-谷氨酰转肽酶与血小板（PLT）比值（GPR）、红细胞分布宽度与PLT比值（RPR）、天冬氨酸氨基转移酶（AST）与丙氨酸氨基转移酶比值（AAR）、AST与PLT比值指数（APRI）以及总胆红素与PLT比值（TPR）。一种名为BARP的新型指数定义为BAR×RPR。本研究共纳入78例PBC患者，其中84.6%有显著纤维化，30.8%有进展期纤维化，15.4%有肝硬化。在多变量分析中，Alb被确定为进展期纤维化的独立预测因子（比值比=0.823，P=0.034）。BAR、GPR、TPR和BARP的受试者工作特征曲线下面积（AUROCs）在预测严重纤维化方面具有统计学意义（P<0.05），分别为0.747、0.684、0.693和0.696。在评估进展期纤维化时，AAR、APRI、BAR、FIB-4、RPR、TPR和BARP的AUROCs分别为0.726、0.650、0.742、0.716、0.670、0.
