Diagnostic value of LSM combined with APRI for liver fibrosis due to chronic hepatitis B

Objective To evaluate the diagnostic value of liver stiffness ( LS) combined with aspartate aminotransferase- to- platelet ratio index ( APRI) for liver fibrosis due to chronic hepatitis B. Methods One hundred and forty- seven patients with chronic hepatitis B admitted to our hospital from August 2009 to January 2013 were staged and grouped according to liver fibrosis pathology. LS was determined with acoustic radiation force impulse, and APRI was calculated from the results of liver function test and routine blood examination. Comparisons between groups were conducted using the analysis of variance. Correlation analysis was performed with the Spearman test. The diagnostic value of LS for liver fibrosis was assessed with the receiver operating characteristic ( ROC) curve. The areas under the ROC curve ( AUC) of LS and APRI, either alone or in combination, for diagnoses of S ≥1 ( presence of liver fibrosis) and S ≥2 ( significant liver fibrosis) were compared. Results Age, LS, aspartate aminotransferase ( AST) , platelet count ( PLT) , and APRI differed significantly across the groups ( P<0. 05) . LS and APRI were strongly correlated with pathological stages, with correlation coefficients of 0. 793 and 0. 699 ( P <0. 05) .The correlation coefficients of AST and PLT with pathological stages were 0. 292 and- 0. 230 ( P < 0. 05) . The AUCs of LS, APRI, and LS plus APRI were 0. 843, 0. 818, and 0. 909, respectively, for diagnosis of S ≥1 and 0. 916, 0. 846, and 0. 943, respectively, for diagnosis of S ≥2, suggesting that the joint use of LS and APRI outperforms LS or APRI alone in the diagnosis of liver fibrosis ( P < 0. 05) . Conclusion LS combined with APRI improve the diagnosis of early- stage liver fibrosis.