Bioimpacts. 2015;5(1): 17-23.
doi: 10.15171/bi.2015.05
PMID: 25901293
PMCID: PMC4401163
Scopus ID: 84924853426
WOSID: 000360917600004
  Abstract View: 655
  PDF Download: 344

Original Research

Non-invasive serum fibrosis markers: A study in chronic hepatitis

Mohammadreza Abdollahi 1, Aliasghar Pouri 2 * , Morteza Ghojazadeh 2, Rasoul Estakhri 3, Mohammadhossein Somi 2

1 Young Researchers and Elite Club, Tabriz Branch, Islamic Azad University, Tabriz, Iran
2 Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
3 Department of Pathology, Tabriz University of Medical Sciences, Tabriz, Iran


Introduction: Chronic hepatitis is specified as inflammatory disease of the liver lasting for more than six months. Role of noninvasive fibrosis markers as prognostication factors of the presence or absence of significant fibrosis on liver biopsy of patients with chronic hepatitis is the aim of this study.
Methods: Two hundred twenty-one patients with chronic hepatitis involved in the study between 2011 and 2013. Routine biochemical indices and serum fibrosis markers such as aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), AST to platelet ratio index (APRI) and Fibrosis 4 score (FIB-4) were evaluated, and the histological grade and stage of the liver biopsy specimens were scored according to the Ishak scoring system. Diagnostic accuracies of these markers for prediction of significant fibrosis were assessed by Receiver Operating Characteristic (ROC) curve analysis.
Results: Contemporaneous laboratory indices for imputing AAR, APRI, and FIB-4 were identified with liver biopsies. From all, 135 males (61.1%) and 86 females (38.9%), with mean age of 39.6±14.4 were studied. Significant correlation between stages of fibrosis and FIB-4, APRI and AAR were detected, with a correlation coefficient higher than that of other markers in the patients with Hepatitis B (r = 0.46), C (r = 0.58) and autoimmune hepatitis (r = 0.28). FIB-4 (AUROC = 0.84) and APRI (AUROC = 0.78) were superior to AAR at distinguishing severe fibrosis from mild-to-moderate fibrosis and gave the highest diagnostic accuracy.
Conclusion: Application of these markers was good at distinguishing significant fibrosis and decreased the need for staging liver biopsy specimens among patients with chronic hepatitis.
Keywords: Chronic Hepatitis, Fibrosis, Grade, Noninvasive Markers, Stage
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Submitted: 05 Dec 2014
ePublished: 15 Aug 2017
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