{"title":"突尼斯慢性乙型肝炎患者肝纤维化无创评估的 GPR 评分性能。","authors":"Ikbel Ghachem, Lamine Hamzaoui, Asma Bachali, Chayma Rhimi, Mouna Medhioub, Moufida Mahmoudi, Amal Khsiba, Mohamed Msaddak Azouz","doi":"10.62438/tunismed.v102i10.5091","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Several non-invasive tests (NIT) have been reported for predicting liver fibrosis to avoid percutaneous liver biopsy (PLB).</p><p><strong>Aim: </strong>To evaluate the performance of NIT in Tunisian patients with chronic hepatitis B (CHB).</p><p><strong>Methods: </strong>We calculated the ASAT/platelet ratio index (APRI), GGT-to-platelet ratio (GPR), Fibrosis-4 score (FIB-4), and RDW/platelet ratio (RPR). The accuracy of NIT was compared with the Metavir score for the detection of liver fibrosis stage using the area under the ROC curves (AUROC).</p><p><strong>Results: </strong>Seventy-seven CHB patients were included. For predicting significant fibrosis, the AUROC of GPR (0.81; CI95% [0.68-0.93]; P < 0.001) was significantly higher than that of RPR (0.67; CI95% [0.52-0.82]; P = 0.03) and FIB-4 (0.746; CI95% [0.61-0.88]; P = 0.002), but was similar to APRI (0.88; CI95% [0.79-0.97]; P < 0.001). For advanced fibrosis, the AUROC of GPR (0.93; CI95% [0.84-1]; P < 0.001) was higher than that of RPR (0.83; CI95% [0.69-0.97]; P < 0.001) and FIB-4 (0.88; CI95% [0.76-0.99]; P < 0.001), but similar to APRI (0.93; CI95% [0.87-0.99]; P < 0.001). For predicting cirrhosis, the AUROC of GPR (0.98; CI95% [0.95-1]; P < 0.001) was higher than that of APRI (0.95; CI95% [0.90-1]; P = 0.02), similar to RPR (0.99; CI95% [0.98-1]; P < 0.001) but lower than that of FIB-4 (1; CI95% [1-1]; P < 0.001). In multivariate analysis, APRI (OR = 3.78; P = 0.002) and FIB-4 (OR = 2.65; P = 0.01) were independent predictors of significant fibrosis. GPR was the only independent predictor of advanced fibrosis (OR = 4.64; P = 0.001) and FIB-4 was the independent predictor of cirrhosis (OR = 2.85; P < 0.001).</p><p><strong>Conclusion: </strong>GPR does not demonstrate significant advantages over APRI, FIB-4, and RPR in identifying liver fibrosis in patients with chronic hepatitis B (CHB).</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":"102 10","pages":"715-721"},"PeriodicalIF":0.0000,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574378/pdf/","citationCount":"0","resultStr":"{\"title\":\"Performance of GPR score for non-invasive assessment of liver fibrosis in chronic hepatitis B Tunisian patients.\",\"authors\":\"Ikbel Ghachem, Lamine Hamzaoui, Asma Bachali, Chayma Rhimi, Mouna Medhioub, Moufida Mahmoudi, Amal Khsiba, Mohamed Msaddak Azouz\",\"doi\":\"10.62438/tunismed.v102i10.5091\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Several non-invasive tests (NIT) have been reported for predicting liver fibrosis to avoid percutaneous liver biopsy (PLB).</p><p><strong>Aim: </strong>To evaluate the performance of NIT in Tunisian patients with chronic hepatitis B (CHB).</p><p><strong>Methods: </strong>We calculated the ASAT/platelet ratio index (APRI), GGT-to-platelet ratio (GPR), Fibrosis-4 score (FIB-4), and RDW/platelet ratio (RPR). The accuracy of NIT was compared with the Metavir score for the detection of liver fibrosis stage using the area under the ROC curves (AUROC).</p><p><strong>Results: </strong>Seventy-seven CHB patients were included. For predicting significant fibrosis, the AUROC of GPR (0.81; CI95% [0.68-0.93]; P < 0.001) was significantly higher than that of RPR (0.67; CI95% [0.52-0.82]; P = 0.03) and FIB-4 (0.746; CI95% [0.61-0.88]; P = 0.002), but was similar to APRI (0.88; CI95% [0.79-0.97]; P < 0.001). For advanced fibrosis, the AUROC of GPR (0.93; CI95% [0.84-1]; P < 0.001) was higher than that of RPR (0.83; CI95% [0.69-0.97]; P < 0.001) and FIB-4 (0.88; CI95% [0.76-0.99]; P < 0.001), but similar to APRI (0.93; CI95% [0.87-0.99]; P < 0.001). For predicting cirrhosis, the AUROC of GPR (0.98; CI95% [0.95-1]; P < 0.001) was higher than that of APRI (0.95; CI95% [0.90-1]; P = 0.02), similar to RPR (0.99; CI95% [0.98-1]; P < 0.001) but lower than that of FIB-4 (1; CI95% [1-1]; P < 0.001). In multivariate analysis, APRI (OR = 3.78; P = 0.002) and FIB-4 (OR = 2.65; P = 0.01) were independent predictors of significant fibrosis. GPR was the only independent predictor of advanced fibrosis (OR = 4.64; P = 0.001) and FIB-4 was the independent predictor of cirrhosis (OR = 2.85; P < 0.001).</p><p><strong>Conclusion: </strong>GPR does not demonstrate significant advantages over APRI, FIB-4, and RPR in identifying liver fibrosis in patients with chronic hepatitis B (CHB).</p>\",\"PeriodicalId\":38818,\"journal\":{\"name\":\"Tunisie Medicale\",\"volume\":\"102 10\",\"pages\":\"715-721\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574378/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Tunisie Medicale\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.62438/tunismed.v102i10.5091\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tunisie Medicale","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.62438/tunismed.v102i10.5091","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Performance of GPR score for non-invasive assessment of liver fibrosis in chronic hepatitis B Tunisian patients.
Introduction: Several non-invasive tests (NIT) have been reported for predicting liver fibrosis to avoid percutaneous liver biopsy (PLB).
Aim: To evaluate the performance of NIT in Tunisian patients with chronic hepatitis B (CHB).
Methods: We calculated the ASAT/platelet ratio index (APRI), GGT-to-platelet ratio (GPR), Fibrosis-4 score (FIB-4), and RDW/platelet ratio (RPR). The accuracy of NIT was compared with the Metavir score for the detection of liver fibrosis stage using the area under the ROC curves (AUROC).
Results: Seventy-seven CHB patients were included. For predicting significant fibrosis, the AUROC of GPR (0.81; CI95% [0.68-0.93]; P < 0.001) was significantly higher than that of RPR (0.67; CI95% [0.52-0.82]; P = 0.03) and FIB-4 (0.746; CI95% [0.61-0.88]; P = 0.002), but was similar to APRI (0.88; CI95% [0.79-0.97]; P < 0.001). For advanced fibrosis, the AUROC of GPR (0.93; CI95% [0.84-1]; P < 0.001) was higher than that of RPR (0.83; CI95% [0.69-0.97]; P < 0.001) and FIB-4 (0.88; CI95% [0.76-0.99]; P < 0.001), but similar to APRI (0.93; CI95% [0.87-0.99]; P < 0.001). For predicting cirrhosis, the AUROC of GPR (0.98; CI95% [0.95-1]; P < 0.001) was higher than that of APRI (0.95; CI95% [0.90-1]; P = 0.02), similar to RPR (0.99; CI95% [0.98-1]; P < 0.001) but lower than that of FIB-4 (1; CI95% [1-1]; P < 0.001). In multivariate analysis, APRI (OR = 3.78; P = 0.002) and FIB-4 (OR = 2.65; P = 0.01) were independent predictors of significant fibrosis. GPR was the only independent predictor of advanced fibrosis (OR = 4.64; P = 0.001) and FIB-4 was the independent predictor of cirrhosis (OR = 2.85; P < 0.001).
Conclusion: GPR does not demonstrate significant advantages over APRI, FIB-4, and RPR in identifying liver fibrosis in patients with chronic hepatitis B (CHB).