Features Of Liver Histopathology In 221 Cases Of Chronic Hepatitis B Patients And Their Associated Factors

ObjectiveTo probe into the features of liver histological changes in chronic hepatitis B patients and their related factors.MethodsTo analyze the characteristics of liver histological abnormalities in different HBeAg conditions and the relationship between histological change and routine clinical index as well.And all the subjects were treatment-naive chronic hepatitis B (CHB) patients with liver biopsy patients.One group included 128 HBeAg-positive CHB and the other group included 93 HBeAg-negtive CHB patients; All statistical analyses were performed using SPSS 13.0. Each parameter was given as mean±SD or no.(%). The chi-squared test was used for categorical variables, and Fischer’s test where appropriate. Correlation was evaluated by the Spearman correlation coefficient. The independent discriminative values of the markers were determined using stepwise forward multiple logistic regression.The diagnostic value of each formula was assessed by the area under the receiver operating characteristic (ROC) curves. A 2-sided P value of less than 0.05 was considered statistically significant.Results1. Chronic hepatitis B patients (n=221), with different level of ALT the frequency of significant inflammation stratified was ALT≤ULN 18.6%(8/44), ALT 1-2×ULN 40.26%(31/77) and ALT>2×ULN group 81.19%(82/101),while significant fibrosis was ALT≤ULN 20.93%(9/44), ALT 1-2×ULN 37.66% (29/77) and ALT>2×ULN group 62.38%(63/101), respectively. Frequencies of significant histological changes in patients with ALT>2×ULN were much higher than in patients with ALT≤ULN and ALT 1-2×ULN (bothP≤0.001).2. Univariate and multivariate analyses both indicated that ALT, AST, ALb were associated with significant inflammation, ALT, AST accurately predicted G2-G4 inflammation (areas under receiver operating characteristic (ROC) curves (AUROC) (0.829～0.854±0.03).3. Univariate and multivariate analyses both indicated that AST, GGT, AKP and PLT were related with significant fibrosis. AST to platelet ratio index (APRI) and an index including AST, PLT, AKP and GGT (APAG=0.034× AST-0.020 ×PLT+0.020 X AKP+0.016 X GGT) accurately predicted S2-S4 fibrosis (AUROC,0.838-0.874±0.03).Conclusion1. Significant progression of liver inflammation and fibrosisis were common in CHB patients with normal or minimally raised ALT.2. APAG is accurately predicted noninvasive markers of HBV-related significant fibrosis.