Gut and Liver 2007; 1(2): 145-150 https://doi.org/10.5009/gnl.2007.1.2.145 Simple Tests to Predict Hepatic Fibrosis in Nonalcoholic Chronic Liver Diseases
Author Information
Woon Geon Shin*, Sang Hoon Park*, Sun-Young Jun, Jae One Jung*, Joon Ho Moon*, Jong Pyo Kim*, Kyoung Oh Kim*, Cheol Hee Park*, Tai Ho Hahn*, Kyo-Sang Yoo*, Jong Hyeok Kim*, and Choong Kee Park*
Departments of *Internal Medicine and Pathology, Hallym Universtiy Sacred Heart Hospital of Hallym Universtiy Medical Center, Anyang, Korea

Sang Hoon Park
© The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. All rights reserved.

Abstract
Background/Aims: Several simple tests for hepatic fibrosis employ indirect markers. However, the efficacy of using direct and indirect serum markers to predict significant fibrosis in clinical practice is inconclusive. We analyzed the efficacy of a previously reported indirect marker of hepatic fibrosis - the aspartate aminotransferase to platelet ratio index (APRI) - in patients with nonalcoholic chronic liver diseases (CLDs). Methods: A total of 134 patients who underwent a percutaneous liver biopsy with a final diagnosis of chronic hepatitis B (n=93), chronic hepatitis C (n=18), or nonalcoholic fatty liver disease (n=23) were enrolled. A single-blinded pathologist staged fibrosis from F0 to F4 according to the METAVIR system, with significant hepatic fibrosis defined as a METAVIR fibrosis score of ≥2. Results: The mean area under the receiver operating characteristic curve (AUROC) of APRI for predicting significant fibrosis in nonalcoholic CLDs was 0.84 [95% confidence interval (CI), 0.78-0.91]. APRI yielded the highest mean AUROC in the patients with chronic hepatitis B (0.85; 95% CI, 0.771-0.926). The positive predictive value of APRI ≥1.5 for predicting significant fibrosis was 89%. The negative predictive value of APRI <0.5 for excluding significant fibrosis was 80%. Conclusions: APRI might be a simple and noninvasive index for predicting significant fibrosis in nonalcoholic CLDs. (Gut and Liver 2007;1:145-150)
Keywords: Aspartate aminotransferase; Fibrosis; Hepatitis B
Abstract
Background/Aims: Several simple tests for hepatic fibrosis employ indirect markers. However, the efficacy of using direct and indirect serum markers to predict significant fibrosis in clinical practice is inconclusive. We analyzed the efficacy of a previously reported indirect marker of hepatic fibrosis - the aspartate aminotransferase to platelet ratio index (APRI) - in patients with nonalcoholic chronic liver diseases (CLDs). Methods: A total of 134 patients who underwent a percutaneous liver biopsy with a final diagnosis of chronic hepatitis B (n=93), chronic hepatitis C (n=18), or nonalcoholic fatty liver disease (n=23) were enrolled. A single-blinded pathologist staged fibrosis from F0 to F4 according to the METAVIR system, with significant hepatic fibrosis defined as a METAVIR fibrosis score of ≥2. Results: The mean area under the receiver operating characteristic curve (AUROC) of APRI for predicting significant fibrosis in nonalcoholic CLDs was 0.84 [95% confidence interval (CI), 0.78-0.91]. APRI yielded the highest mean AUROC in the patients with chronic hepatitis B (0.85; 95% CI, 0.771-0.926). The positive predictive value of APRI ≥1.5 for predicting significant fibrosis was 89%. The negative predictive value of APRI <0.5 for excluding significant fibrosis was 80%. Conclusions: APRI might be a simple and noninvasive index for predicting significant fibrosis in nonalcoholic CLDs. (Gut and Liver 2007;1:145-150)
Keywords: Aspartate aminotransferase; Fibrosis; Hepatitis B
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