PLATELETS, ASPARTATE AMINOTRANSFERASE, TUMOR NECROSIS FACTOR-α: LABORATORY PANEL FOR DIAGNOSIS OF LIVER FIBROSIS STAGE

Abstract

Aim. To study significance of platelet count and values of aspartate aminotransferase and tumor necrosis factor-α in the evaluation of the severity of liver fibrosis in chronic hepatitis C and for the development of fibrosis index calculation formula.Material and Methods. The study included 70 patients with chronic hepatitis C end 30 healthy persons. Liver density was estimated by ultrasound elastography.Results. The correlation analysis revealed strong relationships between the ultrasound elastography findings of fibrosis stage and the platelet count (r=0.83), aspartate aminotransferase (r=0.83), and tumor necrosis factor-α (r=0.81). The optimal separation points of laboratory tests for fibrosis exclusion were identified as follows: platelet count>270×109 /L (test sensitivity=96.2%), aspartate aminotransferase level<44 E/L (sensitivity=96.2%), and tumor necrosis factor-α concentration below 1.9 pg/mL (sensitivity=92.3%). The obtained values of laboratory parameters were used for calculation of the liver fibrosis index. The value of the fibrosis index ranging between 0 and 0.5 indicated the absence of fibrosis (stage F0), the value of the fibrosis index ranging between 0.6 and 2.5 corresponded to the moderate stage of fibrosis (F1-2), and the value of the fibrosis index>2.5 corresponded to the severe fibrosis/cirrhosis of the liver (F3-4) with diagnostic sensitivity of 83% and specificity of 78%.Conclusion. Platelet count, the values of aspartate aminotransferase and tumor necrosis factor-α levels, fibrosis index, and laboratory test data can be used for ruling out fibrosis in chronic hepatitis C patients as well as for stratification of liver fibrosis stages.