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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 7
Jul.  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(7): 1529-1533

Application value of liver stiffness measurement-to-platelet ratio index score in diagnosis of hepatitis B liver fibrosis and liver cirrhosis

DOI: 10.3969/j.issn.1001-5256.2022.07.014
  • 1.

    Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

  • 2.

    National Clinical Research Center for Digestive Diseases, Beijing 100050, China

Research funding:

National Science and Technology Major Project (2013ZX10002004);

WBE Liver Fibrosis Foundation (CFHPC2022029)

More Information
  • Corresponding author: WU Xiaoning, wuxiaoningbs@126.com(ORCID: 0000-0001-5416-712X)
  • Received Date: 2022-02-10
  • Accepted Date: 2022-04-02
  • Published Date: 2022-07-20
    Abstract
  •   Objective  To investigate the diagnostic value of liver stiffness measurement-to-platelet ratio index (LPRI) score in previously untreated patients with hepatitis B liver fibrosis/liver cirrhosis, since the evaluation of liver fibrosis degree has great significance in guiding the treatment of chronic hepatitis B patients and predicting their prognosis.  Methods  A total of 276 chronic hepatitis B patients who were diagnosed by liver biopsy from June 2013 to September 2015 were selected from the hepatitis B study cohort of Beijing Friendship Hospital, Capital Medical University. LPRI score was calculated based on liver stiffness measurement (LSM) and platelet, and the value of LPRI score in the diagnosis of liver fibrosis and liver cirrhosis in hepatitis B patients was evaluated with liver pathology as the gold standard. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the chi-square test was used for comparison of categorical data between groups. A Spearman correlation analysis was used to investigate the correlation between each diagnostic model and liver biopsy, and the DeLong test was used to compare the area under the ROC curve (AUC) and diagnostic performance of several noninvasive diagnostic models, i.e., LPRI, LSM, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4). The Bootstrap method was used for the internal validation of the value of LPRI score in the diagnosis of liver fibrosis/cirrhosis.  Results  According to the stage of liver fibrosis, the patients were divided into F0/1 group with 63 patients, F2/3 group with 118 patients, and F4 group with 95 patients, and there were significant differences in albumin, total bilirubin, platelet count, LSM, alpha-fetoprotein, and HBV DNA between the three groups (all P < 0.05). LPRI score was significantly correlated with liver biopsy (r=0.501, P < 0.001); LPRI score had an AUC of 0.88 (95% confidence interval [CI]: 0.83-0.91) in the diagnosis of liver fibrosis and an AUC of 0.79 (95% CI: 0.73-0.83) in the diagnosis of liver cirrhosis, suggesting that the diagnostic performance of LPRI score for significant liver fibrosis was better than that for liver cirrhosis. LPRI had a better diagnostic performance than APRI and FIB-4 (both P < 0.05), and in combination with LSM, LPRI score further supplemented the sensitivity of LSM in the diagnosis of liver cirrhosis, with an increase from 53% to 82%. The cut-off values of LPRI score recommended by Youden index were 6.1 (with a sensitivity of 71% and a specificity of 92%) for significant liver fibrosis and 6.9 (with a sensitivity of 81% and a specificity of 66%) for liver cirrhosis.  Conclusion  As a simple and convenient noninvasive diagnostic index for liver fibrosis, LPRI score has a certain application value in the diagnosis and staging of liver fibrosis and liver cirrhosis in chronic hepatitis B patients.

     

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