Diagnostic Value Of Fibroscan And GUCI Score For Chronic Hepatitis B Fibrosis

Objective To evaluate the diagnostic value of Fibroscan and GUCI score for chronic hepatitis B fibrosis.Methods A total of 227 cases of CHB infected patients who visited Ningxia Medical University General Hospital for liver puncture biopsy from September 2016 to September2021 were retrospectively collected,and the Fibroscan test was performed on the day before or on the day of liver biopsy,and the liver stiffness value(LSM)was recorded,and the GUCI score,APRI score and FIB-4 index were calculated by the relevant serological indexes,respectively.Spearman analysis was used to analyze the correlation between LSM values,GUCI score,APRI score,FIB-4 index and the degree of liver fibrosis.ROC curves were mapped to assess the efficiency of Fibroscan and GUCI score in testing for significant liver fibrosis(S2-4),progressive liver fibrosis(S3-4)and cirrhosis(S4).Results1.Depending on the patient’s fibrosis S score increased,the PT(H=30.041),INR(H=37.498),AST(H=19.873),RDW(H=34.311),LSM value(H=70.063),GUCI score(H=58.063),APRI score(H=52.479),FIB-4 index(H= 43.281)gradually increased,while PLT(F=19.064)gradually decreased,all of which were statistically different(P<0.05),and age(F=1.953),gender(χ2=1.952),BMI(F=1.921),TBIL(H=9.313),ALT(H=5.964),ALB(H=6.864),HBe Ag(+/-)(χ2=2.910)were not statistically different(P>0.05).2.Spearman correlation analysis: AST,GGT,INR,IV-C,HAwere significantly correlated with the stage of liver fibrosis(P<0.05),with r values of 0.254,0.254,0.360,0.328,0.334,respectively;PLT was adversely correlated with the stage of liver fibrosis(P<0.05),with an r value of-0.472;while ALT,TBIL,and PIIINP were not correlated with liver fibrosis,with r values of 0.052,0.113,and 0.104,respectively(P>0.05).LSM,GUCI score,APRI score,and FIB-4 index were significantly correlated with the stage of liver fibrosis(P<0.05),with r values of 0.519,0.483,0.455,and 0.393,respectively.3.ROC curve analysis showed that the AUC of LSM value,GUCI score,APRI score and FIB-4 for the diagnosis of significant liver fibrosis group(S2～4)were 0.774,0.732,0.715 and0.696,P<0.05;for the diagnosis of progressive liver fibrosis group(S3～4)were 0.750,0.721,0.707,P<0.05 and the AUC for the diagnosis of cirrhosis(S4)were 0.838,0.818,0.809 and0.794 in that sequence,P<0.05.Among the subgroups,Fibroscan had the best diagnostic efficacy for fibrosis;in the serological model,GUCI score had better diagnostic efficacy than APRI score and FIB-4 index.4.There was no significant difference in the diagnostic efficacy of LSM combined with GUCI score,APRI score and Fib-4 when compared with LSM alone in patients with ≥ S2,≥S3 and S4 groups(P > 0.05),but it can improve the diagnostic sensitivity.ConclusionFibroscan and GUCI score values showed consistent evaluation of slow hepatitis B fibrosis,which has some diagnostic value.