Retrospective Evaluation of Serum Markers APRI and AST/ALT for Assessing Liver Fibrosis and Cirrhosis in Chronic Hepatitis B and C Patients with Hepatocellular Carcinoma

Lin, Chensheng; Chang, Chi-Sen; Yang, Sheng‐Shun; Yeh, Hong-Zen; Lin, Cheng‐Wen

doi:10.2169/internalmedicine.47.0595

Cited by 62 publications

(54 citation statements)

References 23 publications

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“…Although liver biopsy remains the gold standard method for the assessment of hepatic fibrosis, it has some limitations (3,4,6,7,(10)(11)(12)(13)(14)(15). In order to overcome these limitations, several noninvasive blood tests, such as AP-RI (7), the Forns index (12), FIB-4 (15,16), Fibroindex (14), Fibrotest (17), Fibrometer (18), and Hepascore (19), have been developed to predict hepatic fibrosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, it has some limitations. It is an invasive procedure and has serious complications in 0.5% of patients including even death (3,4,6,(9)(10)(11)(12)(13). It cannot be performed in patients with impaired hemostasis (11,13).…”

Section: Introductionmentioning

confidence: 99%

“…It is an invasive procedure and has serious complications in 0.5% of patients including even death (3,4,6,(9)(10)(11)(12)(13). It cannot be performed in patients with impaired hemostasis (11,13). Since the biopsy specimens represent 1/50,000 of the liver, it can lead to under-or overestimation of the degree of hepatic fibrosis (6,7,13,14).…”

Section: Introductionmentioning

confidence: 99%

“…It cannot be performed in patients with impaired hemostasis (11,13). Since the biopsy specimens represent 1/50,000 of the liver, it can lead to under-or overestimation of the degree of hepatic fibrosis (6,7,13,14). Inter-and intraobserver discrepancies of 10% to 20% are other limitations (3,6,7,10,14).…”

Section: Introductionmentioning

confidence: 99%

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AST-platelet ratio index, Forns index and FIB-4 in the prediction of significant fibrosis and cirrhosis in patients with chronic hepatitis C

Güzelbulut

Çetinkaya²,

Sezıklı³

et al. 2011

Turk J Gastroenterol

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Amaç: Bu çal›flmadaki amac›m›z kronik hepatit C'li hastalarda belirgin fibrozis ve sirozun belirlenmesinde aspartat aminotransferaz-platelet oran› indeksi, Forns indeksi ve FIB-4'ün tan›sal güvenilirli¤ini karaci¤er biopsisi ile karfl›laflt›rmal› olarak de¤erlen-dirmektir. Metod: 2004de¤erlen-dirmektir. Metod: -2008 Background/aims: The aim of this study was to evaluate the diagnostic accuracy of aspartate aminotransferase-platelet ratio index, the Forns index and FIB-4 for the assessment of hepatic fibrosis in chronic hepatitis C patients by comparison with liver biopsy. Methods: We retrospectively reviewed our computerized data of chronic hepatitis C patients who admitted to the Gastroenterology Clinic between 2004 and 2008. Treatment-naive chronic hepatitis C patients who had undergone liver biopsy and had laboratory test results allowing the calculation of aspartate aminotransferase-platelet ratio index, the Forns index and FIB-4 were included in this study. The degree of fibrosis was scored according to the METAVIR staging system. Significant fibrosis was defined as F2-4 and cirrhosis as F4. Aspartate aminotransferase-platelet ratio index, the Forns index and FIB-4 were calculated based on the original studies. Tests results were compared between groups F0-1 (no or mild fibrosis) versus F2-4 (significant fibrosis) and F0-3 (no cirrhosis) versus F4 (cirrhosis). Results: One hundred and fifty patients with chronic hepatitis C were included in this study. The areas under the ROC curves of the Forns index, aspartate aminotransferase-platelet ratio index and FIB-4 to

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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AST-platelet ratio index, Forns index and FIB-4 in the prediction of significant fibrosis and cirrhosis in patients with chronic hepatitis C

Güzelbulut

Çetinkaya²,

Sezıklı³

et al. 2011

Turk J Gastroenterol

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“…В некоторых работах показано, что повышение активности NK-клеток приводит к более выраженному цито-лизу гепатоцитов, свидетельством чего является повышение активности АЛТ [3]. В то же время повышение активности АСТ, превалирующее над активностью АЛТ, может свидетельствовать о на-чинающемся развитии фибротических измене-ний печени [8].…”

Section: результаты и обсуждениеunclassified

Features of Nk-Cell Contents in Patients With Chronic Hepatitis C

et al. 2014

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Резюме. При хроническом гепатите С течение и исход заболевания зависят от состояния клеточно-го звена иммунитета. Мы проанализировали показатели относительного и абсолютного содержания NK-клеток (CD3 -CD16 + CD56 + ) и их активированных форм (CD3 -CD16 + CD56 + CD107 + a), оценивае-мых по экспрессии LAMP-белка (CD107a) в периферической крови у 70 больных с верифицирован-ным диагнозом хронический гепатит С. Выявлено значительное снижение цитотоксического потен-циала натуральных киллеров у больных хроническим гепатитом С на фоне нормального абсолютного содержания NK-клеток. Установлено, что уровень NK-клеток и их активированных форм не отлича-ются у больных, инфицированных вирусами 1 и 3 генотипа, а также при высокой и низкой вирусной нагрузке. При анализе взаимосвязи между содержанием активированных форм NK-клеток и уровнем биохимических маркеров цитолитического и холестатического синдромов была установлена прямая корреляционная связь с активностью АСТ и обратная корреляционная связь с активностью ГГТП и щелочной фосфатазы. Полученные данные позволяют предположить возможную роль нарушения активации NK-клеток в патогенезе хронического гепатита С. 1 vs 3). Likewise, they did not differ between the patients with higher and lower viral load. When analyzing relationships between the contents of activated NK cells and levels of biochemical markers of cytolytic and cholestatic syndromes, we have found a direct correlation with AST activity, and an inverse correlation with the of GGT and alkaline phosphatase activities. The data suggest a possible role of altered NK cell activation in pathogenesis of chronic hepatitis C.

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Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis‐4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: A systemic review and meta‐analysis

2014

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The aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on the four factors (Fibrosis 4 index; FIB-4) are the two most widely studied noninvasive tools for assessing liver fibrosis. Our aims were to systematically review the performance of APRI and FIB-4 in hepatitis B virus (HBV) infection in adult patients and compare their advantages and disadvantages. We examined the diagnostic accuracy of APRI and FIB-4 for significant fibrosis, advanced fibrosis, and cirrhosis based on their sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUROC). Heterogeneity was explored using metaregression. Our systemic review and meta-analysis included 16 articles of APRI only, 21 articles of APRI and FIB-4 and two articles of FIB-4 for detecting different levels of liver fibrosis. With an APRI threshold of 0.5, 1.0, and 1.5, the sensitivity and specificity values were 70.0% and 60.0%, 50.0% and 83.0%, and 36.9% and 92.5% for significant fibrosis, advanced fibrosis, and cirrhosis, respectively. With an FIB-4 threshold of 1.45 and 3.25, the sensitivity and specificity values were 65.4% and 73.6% and 16.2% and 95.2% for significant fibrosis. The summary AUROC values using APRI and FIB-4 for the diagnosis of significant fibrosis, advanced fibrosis, and cirrhosis were 0.7407 (95% confidence interval [CI]: 0.7033-0.7781) and 0.7844 (95% CI: 0.7450-0.8238; (Z 5 1.59, P 5 0.06), 0.7347 (95% CI: 0.6790-0.7904) and 0.8165 (95% CI: 0.7707-0.8623; Z 5 2.01, P 5 0.02), and 0.7268 (95% CI: 0.6578-0.7958) and 0.8448 (95% CI: 0.7742-0.9154; (Z 5 2.34, P 5 0.01), respectively. Conclusions: Our meta-analysis suggests that APRI and FIB-4 can identify hepatitis B-related fibrosis with a moderate sensitivity and accuracy. (HEPATOLOGY 2015;61:292-302)

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Retrospective Evaluation of Serum Markers APRI and AST/ALT for Assessing Liver Fibrosis and Cirrhosis in Chronic Hepatitis B and C Patients with Hepatocellular Carcinoma

Abstract: Objective Aspartate aminotransferase-to-platelet ratio index (APRI)

Cited by 62 publications

References 23 publications

AST-platelet ratio index, Forns index and FIB-4 in the prediction of significant fibrosis and cirrhosis in patients with chronic hepatitis C

AST-platelet ratio index, Forns index and FIB-4 in the prediction of significant fibrosis and cirrhosis in patients with chronic hepatitis C

Features of Nk-Cell Contents in Patients With Chronic Hepatitis C

Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis‐4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: A systemic review and meta‐analysis

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