A Study On The Relationship Between The Hepatic Histological Changes And Clinical Manif Estations And Building A Prediction Model In The Chronic Patients Infected With HBV

Objective :After investigating the relationship between hepatic histopathological changes and clinical characteristics in patients with chronic HBV infection,we found the Serum markers Most closely associated with Inflammation grades and fibrosis stages and finally we built a simple model by the composition of these serum markers to predict significant inflammation and significant fibrosis , provided a convenient noninvasive substitute for liver biopsies.Methods:A total of 826 patients with chronic HBV infection were randomly divided into two cohorts: training group (N =547) and validation group (N = 279). , correlation between the conventional laboratory markers and Inflammation grades and fibrosis stages was assessed using statistical analysis.The diagnostic value of the related markers was assessed together with Inflammation grades and fibrosis stages using the receiver operating characteristic curves(ROC) and Spearman correlation coefficient. and a diagnostic model was established by using statistical analysis such as Logistic regression. The diagnostic value of the noveI model was assessed together with AAR,API,APRI index,S index and Mohamadnejad model using the receiver operating characteristic curves(ROC).Results:In the relationship with clinical manifestations and inflammation grades, the level of serum HBV DNA was associated with the extent of in?ammation,the middle-load group was most serious, followed by the high-load group, the low-load group is the lightest.However, different HBeAg status, age,history length, repeated liver function abnormalities and family history of hepatitis B were not significantly associated with the extent of in?ammation.The largest area unden ROC(AUROC) to assessed inflammation grades and fibrosis stages was glutamyltransferase(GGT),0.803,and its Spearman correlation coefficient r=0.475. Followed by hyaluronidase (HA), AUROC was 0.770, r=0.410~.In the relationship with clinical manifestations and fibrosis stages, the level of serum HBV DNA was associated with significant fibrosis and advanced cirrhosis; There was a significant trend for significant fibrosis and advanced cirrhosis to be more common in older patients over age 30 ,More than patients Under 30 years of age. Similarly, different HBeAg status, age,history length, repeated liver function abnormalities and family history of hepatitis B were not significantly associated with significant fibrosis and advanced cirrhosis.The largest area unden ROC(AUROC) to assessed fibrosis stages was HA,its AUROC corresponding to which was 0.789,0.833.and correlation coefficient was 0.497,0.467, respectively. IF index ,composed of four conventional markers GGT, HA, platelet (PLT) and albumin (Alb) , Have high diagnostic value to assess significant inflammation,significant fibrosis and advanced cirrhosis. its AUROC corresponding to which was 0.843,0.806 and 0.813 in the training cohort,and 0.833,0,813,0.772 in the validation cohort, respectively. Compared with the other models,the bettle model for predicting significant in?ammation was Mohamadnejad model with an AUC of 0.780 in the validation group, and S index was the bettle model for predicting significant fibrosis and advanced cirrhosis with an AUROC over 0.780 in the validation group. Whereas,the AUROC of the other models such as AAR,API and APRI were under 0.7.Conclusions:IF index, a simpler mathematical model consisting of routine laboratory markers predicts significant inflammation ,significant fibrosis and advanced cirrhosis in patients with chronic HBV infection with a high degree of accuracy, And was convenient for clinical application. very likely decrease the need for liver biopsy.