Value of gamma-glutamyl transpeptidase-to-platelet ratio in predicting liver fibrosis stage in chronic hepatitis B patients in Guangdong, China

Objective To investigate the value of gamma-glutamyl transpeptidase-to-platelet ratio (GPR) in predicting liver fibrosis stage in chronic hepatitis B (CHB) patients in Guangdong, China. Methods A total of 501 patients who were diagnosed with CHB by liver biopsy in Guangzhou 8 th People's Hospital from January 2010 to December 2016 were enrolled, among whom 335 had HBe Ag-positive CHB and 166 had HBe Ag-negative CHB. The value of GPR, gamma-glutamyl transpeptidase (GGT) , aspartate aminotransferase-to-platelet ratio index (APRI) , and fibrosis-4 (FIB-4) in predicting liver fibrosis stage (F1-F4) was analyzed. The Spearman correlation coefficient was used to analyze the correlation between diagnostic models and liver fibrosis stage, and the area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the value of each model in predicting liver fibrosis stage. Results With liver biopsy as the gold standard, of all patients, 141 had F1 stage, 183 had F2 stage, 139 had F3 stage, and 38 had F4 stage disease. The Spearman correlation analysis showed that in HBe Ag-positive and HBe Ag-negative patients, GGT, GPR, APRI, and FIB-4 were positively correlated with liver fibrosis stage (r = 0. 459, 0. 526, 0. 320, 0. 470, 0. 272, 0. 366, 0. 288, and 0. 388, all P < 0. 001) , and platelet count (PLT) was negatively correlated with liver fibrosis stage (r =-0. 333 and-0. 349, both P < 0. 001) . The ROC curve analysis showed that compared with GGT and APRI, GPR had a significantly better value in predicting marked fibrosis (≥F2) , advanced fibrosis (≥F3) , and early cirrhosis (F4) (all P < 0. 05) in HBe Ag-positive CHB patients, and GPR had a similar predictive value as FIB-4 (P > 0. 05) ; in HBe Ag-negative CHB patients, GPR had a significantly better value in predicting marked fibrosis (≥F2) than GGT and APRI (both P <0. 05) and a significantly better value in predicting advanced fibrosis (≥F3) than GGT (P < 0. 05) , while GPR had a similar value as GGT, APRI, and FIB-4 in predicting early cirrhosis (F4) (all P > 0. 05) . Conclusion GPR can be used as a noninvasive biochemical index for liver fibrosis stage in CHB patients in Guangdong, and in HBe Ag-positive CHB patients, GPR has a comparable predictive value to FIB-4 and APRI.