Diagnostic Accuracy of Red Cell Distribution Width to Platelet Ratio for Detection of Liver Fibrosis Compared with Fibroscan in Chronic Hepatitis B Egyptian patients
Amira Kamal Gabr, N. Hawash, S. Abd-Elsalam, R. Badawi, Hanan H Soliman
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引用次数: 0
Abstract
The decision to treat chronic hepatitis B Virus infection (CHB) may necessitate an assessment of the degree of liver fibrosis. Guidelines recommend Fibroscan examination in such cases. However, it is costly and not widely available. Red cell distribution width (RDW) and platelet count are simple parameters obtained from the blood pictures; and their ratio RDW to platelet ratio (RPR) was claimed to correlate with liver fibrosis. We aimed to assess the ability of RPR to replace the costly fibroscan in the detection of significant fibrosis in chronic hepatitis B patients.
This cross-sectional study was conducted in the Tropical medicine department, Tanta University, Egypt, between December 2018 and September 2019. One hundred and twenty-five patients with CHB were included and divided according to the fibroscan examination into: Group I: patients with no significant fibrosis (n=66), Group II: patients with significant (≥ F2) fibrosis (n=59). RPR was calculated for all patients and tested against Fibroscan results.
Both groups were matched in regards to age, sex, viral load, and steatosis. There was a significant positive correlation between the degree of stiffness measured by FibroScan in patients with a significant degree of fibrosis and serum bilirubin, a quantitative polymerase chain reaction of hepatitis B virus DNA (HBV DNA PCR), and fibrosis-4 score (FIB-4 score) (P value= 0.020, 0.049, and 0.0402, respectively). However, RPR was not correlated to the degree of fibrosis in fibroscan examination.
The accuracy of RDW to platelet ratio (RPR) for the detection of fibrosis in CHB patients is questionable. FIB-4 is correlated with liver stiffness measurement (LSM) in patients with significant fibrosis (F2 or more). Neither RPR, AST to Platelet Ratio Index (APRI) or FIB4 can replace fibroscan for grading of fibrosis in CHB patients for evaluation to start therapy.
决定治疗慢性乙型肝炎病毒感染(CHB)可能需要评估肝纤维化的程度。指南建议在这种情况下进行纤维扫描检查。然而,它成本高昂,而且没有广泛使用。红细胞分布宽度(RDW)和血小板计数是从血液图片中获得的简单参数;并且它们的RDW与血小板比率(RPR)被认为与肝纤维化相关。我们的目的是评估RPR取代昂贵的纤维扫描检测慢性乙型肝炎患者显著纤维化的能力。这项横断面研究于2018年12月至2019年9月在埃及坦塔大学热带医学系进行。125例慢性乙型肝炎患者被纳入,并根据纤维扫描检查分为:第一组:无明显纤维化的患者(n=66),第二组:有明显(≥F2)纤维化的病人(n=59)。计算所有患者的RPR,并对照Fibroscan结果进行测试。两组在年龄、性别、病毒载量和脂肪变性方面匹配。在具有显著纤维化程度的患者中,通过FibroScan测量的硬度与血清胆红素、乙型肝炎病毒DNA的定量聚合酶链式反应(HBV DNA PCR)和纤维化-4评分(FIB-4评分)之间存在显著的正相关(P值分别为0.020、0.049和0.0402)。然而,在纤维扫描检查中,RPR与纤维化程度无关。RDW与血小板比值(RPR)检测慢性乙型肝炎患者纤维化的准确性值得怀疑。FIB-4与具有显著纤维化(F2或以上)的患者的肝硬度测量(LSM)相关。RPR、AST与血小板比值指数(APRI)或FIB4都不能取代纤维扫描来对慢性乙型肝炎患者的纤维化进行分级,以评估开始治疗。
期刊介绍:
The Open Biomarkers Journal is an Open Access online journal, which publishes original full-length, short research articles and reviews on biomarkers in clinical, medical and pharmaceutical research. The coverage includes biomarkers of disease, new biomarkers, exposure to drugs, genetic effects, and applications of biomarkers. The Open Biomarkers Journal, a peer reviewed journal, aims to provide the most complete and reliable source of information on current developments in the field. The emphasis will be on publishing quality articles rapidly and freely available to researchers worldwide.