Noninvasive assessment of hepatic fibrosis in Egyptian patients with chronic hepatitis C virus infection

作者：Fouad Shawky Abdelhamid; Esmat Serag^*; Omran Dalia; Rashid Laila; Kobaisi Mohamed H

来源：World Journal of Gastroenterology, 2012, 18(23): 2988-2994.

DOI：10.3748/wjg.v18.i23.2988

• Age platelet index
• Aspartate aminotransferase platelet ratio index
• Aspartate aminotransferase-to-alanine aminotransferase ratio
• Cirrhosis discriminating score
• Fibrosis evaluation
• Goteborg University Cirrhosis Index
• Hepatitis C virus infection
• Liver fibrosis
• Pohl score

AIM: To evaluate the accuracy of specific biochemical markers for the assessment of hepatic fibrosis in patients with chronic hepatitis C virus (HCV) infection. %26lt;br%26gt;METHODS: One hundred and fifty-four patients with chronic HCV infection were included in this study; 124 patients were non-cirrhotic, and 30 were cirrhotic. The following measurements were obtained in all patients: serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, total bilirubin, prothrombin time and concentration, complete blood count, hepatitis B surface antigen (HBsAg), HCVAb, HCV-RNA by quantitative polymerase chain reaction, abdominal ultrasound and ultrasonic-guided liver biopsy. The following ratios, scores and indices were calculated and compared with the results of the histopathological examination: AST/ALT ratio (AAR), age platelet index (API), AST to platelet ratio index (APRI), cirrhosis discriminating score (CDS), Pohl score, Goteborg University Cirrhosis Index (GUCI). %26lt;br%26gt;RESULTS: AAR, APRI, API and GUCI demonstrated good diagnostic accuracy of liver cirrhosis (80.5%, 79.2%, 76.6% and 80.5%, respectively); P values were: %26lt; 0.01, %26lt; 0.05, %26lt; 0.001 and %26lt; 0.001, respectively. Among the studied parameters, AAR and GUCI gave the highest diagnostic accuracy (80.5%) with cutoff values of 1.2 and 1.5, respectively. APRI, API and GUCI were significantly correlated with the stage of fibrosis (P %26lt; 0.001) and the grade of activity (P %26lt; 0.001, %26lt; 0.001 and %26lt; 0.005, respectively), while CDS only correlated significantly with the stage of fibrosis (P %26lt; 0.001) and not with the degree of activity (P %26gt; 0.05). In addition, we found significant correlations for the AAR, APRI, API, GUCI and Pohl score between the non-cirrhotic (F0, F1, F2, F3) and cirrhotic (F4) groups (P values: %26lt; 0.001, %26lt; 0.05, %26lt; 0.001, %26lt; 0.001 and %26lt; 0.005, respectively; CDS did not demonstrate significant correlation (P %26gt; 0.05). %26lt;br%26gt;CONCLUSION: The use of AAR, APRI, API, GUCI and Pohl score measurements may decrease the need for liver biopsies in diagnosing cirrhosis, especially in Egypt, where resources are limited.

• 出版日期2012-6-21