Comparative Study Of Diagnosis Value Of Noninvasive Liver Fibrosis Model For Chronic Hepatitis B

Objective: To assessment value of the noninvasive diagnostic models for diagnose liver fibrosis and inflammation in patients with chronic hepatitis B.To establish the new non-invasive model for diagnosing the advanced fibrosis.Methods: Compared the value of noninvasive model liverbiopsy with APRI、 FIB-4index、AAR、SPRI、ASPRI 、CP model(Including the CP1 model which is diagnosis inchoate cirrhosis and the CP2 model which is diagnosis signifiantly liver cirrhosis).Receiver Operating Characteristic( ROC) curve was used for evaluation of non-invasive diagnosis models to diagnose signifiantly liver cirrhosis and inchoate liver cirrhosis.All patients were already checked by Serology、imaging and liver biopsy. Analysis the correlation with various influencing factors and progression of liver fibrosis by Spearman rank correlation, independent predictors of screening and build diagnostic model by logistic regression analysis.Compare with the new model and existing models.Results: A total of 174 chronic hepatitis B patients were enrolled, divided into groups on the basis of the result of the liver biopsy: no advanced liver firosis group 64cases(≤S1), advanced liver firosis group 110 cases(≥S2), inchoate liver cirrhosis group21 cases(=S4).APRI、FIB-4 index、AAR、SPRI、ASPRI、CP model existed a favorable coherence with liver biopsy. APRI、FIB-4 index、AAR、SPRI、ASPRI、CP model for diagnosing the advanced fibrosis(Ishak≥S2)were 0.75、0.832、0.738、0.769、0.768、0.864,the AUC(areas under ROC curve) of CP model was the biggest,(Z=2.607、2.374 、2.133、2.325、2.35,P <0.05).the AUC of these model for diagnosing inchoate liver cirrhosis were 0.646、0.633、0.647、0.871、0.819、0.899.The CP model has the highest diagnostic accuracy for diagnosing inchoate cirrhosis(Z=4.063、4.222、4.587、2.059、2.432,P<0.05). we selected out the independent diagnosis factors withdichotomy logistic regression and established the liver fibrosis-diagnosing models L-test. AUC of the model for diagnosing advanced liver cirrhosis was 0.855, the Youden index was 0.673. The sensitivity、specificity、positive predictive value、negative predictive value were 0.855、0.719、0.753、0.883.Compare L-test model with APRI、FIB-4、AAR、SPRI、ASPRI、CP models,L-test model has the same diagnosis value as CP2 model(P=0.788).L-test model has the highest diagnostic accuracy for diagnosing advanced fibrosis(Z=2.645、2.742、3.231、2.264、2.374、6.723,P<0.05).Conclusions: Compear with APRI、FIB-4、AAR、SPRI、ASPRI models,the CP model has good diagnostic values for signifiantly liver cirrhosis and inchoate liver cirrhosis,especially for diagnosing advanced liver cirrhosis early cirrhosis.Create a new model included serology marks and Spleen size to establish L-test model.It can be increase the inspection accuracy.It was maybe reduce the chance of liver biopsy.