Serum markers for predicting significant necroinflammatory activity in patients with chronic hepatitis B

Cho, Hyo Jung; Kim, Soon Sun; Ahn, Sung Jun; Bae, Chang Bum; Kim, Han Gyeol; Kim, Young Jip; Lee, Seung Kyung; Song, Ga Won; Kim, Dong Joon; Hwang, Seong Gyu; Yang, Jin Mo; Kim, Young Bae; Park, Young Nyun; Cho, Sung Won; Cheong, Jae Youn

doi:10.1016/j.clinbiochem.2012.07.107

Cited by 7 publications

(7 citation statements)

References 33 publications

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“…As our previous research has indicated, there is a significant correlation between the grade of inflammation and the stage of fibrosis [17], which is consistent with a study by Cheong et al [14]. Several other studies also indicate the relationship between the grade of inflammation and the stage of fibrosis [12], [13]. In order to predict intrahepatic inflammation in a noninvasive manner, we used LSM instead of stage of fibrosis in our model and the diagnostic performance of the LSM-based activity score was comparable to that of the fibrosis-based activity score.…”

Section: Discussionsupporting

confidence: 89%

“…Multivariate analysis in a previous study has also revealed that the stage of fibrosis is highly predictive of significant inflammation [14]. Moreover, several fibrosis-related serum markers such as hyaluronate and procollagen III N-terminal peptide (PIIINP) are also useful for predicting inflammation [12]–[14]. It seems reasonable to deduct that the correlation between fibrosis and inflammation acts as a “bridge” connecting fibrosis-related serum markers to inflammation.…”

Section: Introductionmentioning

confidence: 94%

“…Several models have been generated for the prediction of inflammatory activity in CHB [4], [12]–[14] and chronic hepatitis C [15], [16]. According to our previous research, the stage of fibrosis is highly correlated with the grade of inflammation [17].…”

Section: Introductionmentioning

confidence: 99%

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Liver Stiffness Measurement-Based Scoring System for Significant Inflammation Related to Chronic Hepatitis B

Hong

Zhang²,

Chen³

et al. 2014

PLoS ONE

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ObjectivesLiver biopsy is indispensable because liver stiffness measurement alone cannot provide information on intrahepatic inflammation. However, the presence of fibrosis highly correlates with inflammation. We constructed a noninvasive model to determine significant inflammation in chronic hepatitis B patients by using liver stiffness measurement and serum markers.MethodsThe training set included chronic hepatitis B patients (n = 327), and the validation set included 106 patients; liver biopsies were performed, liver histology was scored, and serum markers were investigated. All patients underwent liver stiffness measurement.ResultsAn inflammation activity scoring system for significant inflammation was constructed. In the training set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.964, 91.9%, and 90.8% in the HBeAg(+) patients and 0.978, 85.0%, and 94.0% in the HBeAg(−) patients, respectively. In the validation set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.971, 90.5%, and 92.5% in the HBeAg(+) patients and 0.977, 95.2%, and 95.8% in the HBeAg(−) patients. The liver stiffness measurement-based activity score was comparable to that of the fibrosis-based activity score in both HBeAg(+) and HBeAg(−) patients for recognizing significant inflammation (G ≥3).ConclusionsSignificant inflammation can be accurately predicted by this novel method. The liver stiffness measurement-based scoring system can be used without the aid of computers and provides a noninvasive alternative for the prediction of chronic hepatitis B-related significant inflammation.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 94%

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Liver Stiffness Measurement-Based Scoring System for Significant Inflammation Related to Chronic Hepatitis B

Hong

Zhang²,

Chen³

et al. 2014

PLoS ONE

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“…A retrospective study by Cho et al. developed a novel formula in distinguishing patients with or without significant liver inflammation . ALT, hyaluronic acid (HA) and procollagen III N‐terminal peptide (PIIINP) were included in this scoring system.…”

Section: Discussionmentioning

confidence: 99%

A novel index using routine clinical parameters for predicting significant liver inflammation in chronic hepatitis B

Wang

Xia

Zhang

et al. 2018

Journal of Viral Hepatitis

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Identifying the degree of liver inflammation is critical for therapeutic judgement of patients with chronic hepatitis B (CHB). However, we lack indexes which can accurately predict significant liver inflammation in patients with CHB. This study aimed to develop a simple predictive index for liver inflammation in CHB using routine clinical parameters. A total of 519 patients with CHB who underwent liver biopsy were enrolled and randomly divided into training (n = 346) and validation cohorts (n = 173). Based on routine clinical parameters, gamma-glutamyl transpeptidase (GGT; P = 0.031) and platelets (PLT; P < 0.001) were identified as independent predictors of significant inflammation by multivariable analysis in the training cohort. Accordingly, the GGT to PLT ratio (GPR) was developed to amplify the opposing effects for predicting liver inflammation. In the training cohort, the AUCs of GPR in predicting significant inflammation were 0.791 (95% CI: 0.742-0.839), 0.783 (95% CI: 0.717-0.849) and 0.791 (95% CI: 0.716-0.867) in the entire patients with CHB, HBeAg-positive CHB patients and HBeAg-negative CHB patients, respectively. The diagnostic performance of GPR for significant inflammation was significantly superior to that of alanine aminotransferase (ALT), aspartate transaminase (AST) and GGT in all patients with CHB and HBeAg-positive CHB patients, but was comparable with ALT, AST and GGT in HBeAg-negative CHB patients. In the validation cohort, the diagnostic performance of GPR in assessing significant liver inflammation was also superior to other indexes in all patients with CHB and HBeAg-positive CHB patients, but was comparable with GGT in HBeAg-negative CHB patients. Thus, GPR can be a novel and simple index for predicting significant liver inflammation in CHB, especially for HBeAg-positive CHB.

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“…Our previous study found that the stage of fibrosis is highly correlated with the grade of inflammation9, and this finding is supported by another study10. Several models have been proposed for the prediction of inflammatory activity related to CHB10111213. Recently, we reported an LSM-based prediction model for inflammatory activity related to CHB, which has high accuracy with balanced sensitivity and specificity14.…”

mentioning

confidence: 53%

Noninvasive scoring system for significant inflammation related to chronic hepatitis B

Hong

Jin

et al. 2017

Sci Rep

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Although a liver stiffness measurement-based model can precisely predict significant intrahepatic inflammation, transient elastography is not commonly available in a primary care center. Additionally, high body mass index and bilirubinemia have notable effects on the accuracy of transient elastography. The present study aimed to create a noninvasive scoring system for the prediction of intrahepatic inflammatory activity related to chronic hepatitis B, without the aid of transient elastography. A total of 396 patients with chronic hepatitis B were enrolled in the present study. Liver biopsies were performed, liver histology was scored using the Scheuer scoring system, and serum markers and liver function were investigated. Inflammatory activity scoring models were constructed for both hepatitis B envelope antigen (+) and hepatitis B envelope antigen (−) patients. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve were 86.00%, 84.80%, 62.32%, 95.39%, and 0.9219, respectively, in the hepatitis B envelope antigen (+) group and 91.89%, 89.86%, 70.83%, 97.64%, and 0.9691, respectively, in the hepatitis B envelope antigen (−) group. Significant inflammation related to chronic hepatitis B can be predicted with satisfactory accuracy by using our logistic regression-based scoring system.

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Serum markers for predicting significant necroinflammatory activity in patients with chronic hepatitis B

Cited by 7 publications

References 33 publications

Liver Stiffness Measurement-Based Scoring System for Significant Inflammation Related to Chronic Hepatitis B

Liver Stiffness Measurement-Based Scoring System for Significant Inflammation Related to Chronic Hepatitis B

A novel index using routine clinical parameters for predicting significant liver inflammation in chronic hepatitis B

Noninvasive scoring system for significant inflammation related to chronic hepatitis B

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