Evaluation The Hepatic Fibrosis By Gama-glutamyltransferase To QHBsAg Ratio In Patients With Chronic Hepatitis B Virus Infection

Objective Liver biopsy is considered the gold-standard method for the assessment of liver fibrosis has a certain risk, so we need some easy ways to evaluate liver fibrosis urgently. To evaluate the predictive value of serum gamama-glutamyltransferase(γ-GT)and q HBs Ag ratio in patients with chronic hepatitis B virus(HBV)infection, in order to analyze the clinical utility in antiviral therapy.Methods A total of 232 patients with chronic hepatitis B were enrolled and all had liver biopsied at The First Affiliated Hospital of Anhui Medical University in April 2013 to August 2014. All patient’s Serum γ-GT and HBs Ag were detected at The First Affiliated Hospital of Anhui Medical University. Roche provided by the United States chemiluminescence reagents quantitative detection of hepatitis B surface antigen, using the US Beckman Bx800 automatic biochemical analyzer and reagents to detect liver function such as γ-GT, ALT, AST. All patients underwent liver biopsy, liver tissue-fixed, paraffin-embedded sections stained by hematoxylin and eosin staining Van Ge, under an optical microscope with 4% formaldehyde solution. Liver fibrosis was believed to be significant as ≥S2 and to be mild or without fibrosis as less than S2 existed. Computing gamama-glutamyl transferase(γ-GT) and q HBs Ag ratio, application Medcalc 12.0 and SPSS 19.0 software for statistical analysis, diagnostic efficacy of Gq HBs R was assessed at different cut-off values for significant liver fibrosis by using receiver operating characteristic curve(ROC). Calculate the sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV)of each truncationpoint.Evaluating the ratio in different cutoff point for significant to assess the diagnostic value of liver fibrosis.Results The area under ROC(AUC) of Gq HBs R for significant liver fibrosis was 0.704. When the Gq HBs R was greater than 9.570 for significant liver fibrosis, the sensitivity, specificity, PPV and NPV were 49.2%, 88.2%, 84.2% and 57.7%.When the Gq HBs R was >10 for significant liver fibrosis, the specificity and PPV were 88.2% and 83.3%, respectively. When the Gq HBs R was >20 for significant liver fibrosis, specificity and PPV were both 100%. When the Gq HBs R was <2.4 for significant liver fibrosis, the sensitive and NPV were 98.4% and 81.8%. When the Gq HBs R was <2 for significant liver fibrosis, the sensitive and NPV were both 100%. As Gq HBs R gradually increases, its specificity and PPV increase gradually, with the decrease of Gq HBs R gradually, its sensitivity and NPV increase gradually. 40% of patients with liver puncture can be avoided when the specificity and PPV were 88.2% and 83.3%, the sensitivity and NPV were 98.4% and 81.8%. The area under ROC(AUC)of fibrosis index based on the 4 factor(FIB-4), aspartate aminotransferase to platelet ratio inde(APRI),γ-GT and HBs Ag for significant liver fibrosis were 0.638, 0.631, 0.606 and 0.588, all were less efficient as compared to Gq HBs R.Conclusion Gq HBs R this nontraumatic diagnostic model can distinguish whether there is a significant liver fibrosis patients. It can avoid some patients of liver biopsy and may have certain guiding significance for patients with chronic hepatitis B antiviral treatment.