| Objective To investigate the non-invasive diagnostic value of globulin/platelet(GP)model for the stage of liver fibrosis in patients with chronic hepatitis B virus(HBV)infection with alanine aminotransferase(ALT)<2 times the upper limit of normal value(ULN).Methods The clinical data of 659 patients with chronic HBV infection who underwent liver biopsy and ALT <2×ULN in the Second Hospital of Anhui Medical University from 2010 to 2018 were retrospectively analyzed.Spearman correlation analysis was used between liver fibrosis stage and non-invasive model values.The comparison between multiple groups of quantitative data that met the normal distribution used analysis of variance,and the Kruskal-Wallis H rank sum test was used that did not meet the normal distribution.Chi-square test was used to compare the count data between groups.According to the pathology of liver biopsy,patients were divided into significant liver fibrosis(S≥2),severe liver fibrosis(S≥3)and liver cirrhosis(S4).GP model was calculated from the patient’s globulin and platelet data,and the receiver operating characteristic curve(ROC curve)was used to evaluate the diagnostic value of the GP model for liver fibrosis and compared with APRI score and FIB-4 index.Results With the aggravation of liver fibrosis,the value of GP model gradually increased.The GP model was significantly positively correlated with the degree of liver fibrosis(r =0.401,P<0.001).The AUC of GP model for S≥2 was lower than the APRI score and the FIB-4 index(Z=1.959 and 0.400,all P>0.05).The AUC of GP model for S≥3 was lower than the APRI score and FIB-4 index(Z=0.698 and 0.259,all P>0.05).The AUC of GP model for S4 was higher than APRI score and FIB-4 index(Z=0.491 and 0.470,all P> 0.05).The cut-off value,ACU,sensitivity,specificity,positive predictive value,and negative predictive value of the GP model for S≥2 were 2.02,0.709,50.9%,81.2%,66.8%,and 69.0%,respectively.The cut-off value,AUC,sensitivity,specificity,positive predictive value,and negative predictive value of the GP model for S≥3 were 2.25,0.769,60.3%,84.6%,52.7%,and 88.2%,respectively.The cut-off value,AUC,sensitivity,specificity,positive predictive value,and negative predictive value of the GP model for diagnosis of S4 were 2.28,0.834,77.0%,82.2%,35.4%,and 96.6%,respectively.Conclusion For patients with chronic HBV infection with ALT <2×ULN,the GP model is a simple and accurate noninvasive assessment model of liver fibrosis,which has the same clinical value as the APRI score and FIB-4 index. |
