Abstract:
Objective To comparatively analyze the judgment values of three non-invasive score systems (LIF-5,APRI and FIB-4),which were based on common indicators,for treatment indication (≥ G2 or ≥ S2) in chronic HBV infected patients with ALT less than two times of upper limits of normal (ULN).
Methods The data of liver pathology and clinical characteristics in 1 135 chronic HBV infected patients with ALT<2×ULN were analyzed retrospectively.Patients were divided into (
Results There were 505 cases (44.49%) with liver inflammation pathological grading ≥ G2 or fibrosis stage ≥ S2.The constituent ratios of male patients and HBeAg negative,the average age,the average values of ALT,AST,APRI and FIB-4 in (≥ G2 or ≥ S2) group were higher than those in (P<0.01).The diagnostic model (LIF-5)=0.725+0.005×age (y)+0.003×ALT+0.004×AST-0.201×(A/G)-0.002×PLT (109/L).The concentration degree and the judgment value of LIF-5 were higher than APRI and FIB-4.The cutoff values for treatment indication of LIF-5,APRI and FIB-4 were 0.46,0.53 and 1.22,respectively.When the LIF-5 was ≤ 0.30 for treatment indication,the sensitivity and negative predictive value (NPV) were 96.8% and 91.8%.When the LIF-5 was >0.75 for treatment indication,the specificity and positive predictive value (PPV) were 97.3% and 87.1%. Conclusion There are still structural damage with liver inflammation ≥ G2 or fibrosis ≥ S2 in 44.49 per cent chronic HBV infected patients with ALT<2×ULN.The non-invasive score system with LIF-5 could predict treatment indication (≥ G2 or ≥ S2) with high accuracy,and is worth promoting.
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