The predictive values of three noninvasive indices in diagnosis of liver fibrosis in patients with chronic hepatitis B: a comparative study

Objective To investigate the values of Fibro Touch,FIB- 4 index,and aspartate aminotransferase- to- platelet ratio index( APRI) in the diagnosis of liver fibrosis in patients with chronic hepatitis B( CHB). Methods A total of 148 patients with CHB who visited Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region and underwent liver biopsy from September 2013 to May2015 were enrolled and divided into groups according to fibrosis stage. All the patients underwent blood biochemical examination,routine blood tests,and Fibro Touch measurement. Then FIB- 4 and APRI were calculated,and liver stiffness was recorded. The receiver operating characteristic( ROC) curve was used to calculate the area under the ROC curve( AUC) and determine the cut- off value,sensitivity,and specificity. Chi- square test was used for comparison between two groups,and the Pearson rank correlation analysis was also performed. Results Fibro Touch,APRI,and FIB- 4 were well correlated with fibrosis stage( r = 0. 628,0. 486,and 0. 482,respectively,all P < 0. 01).In the marked liver fibrosis( > or =S2) group and liver cirrhosis( S4) group,Fibro Touch had the best diagnostic performance,with AUCs of 0. 84 and 0. 93,respectively,followed by APRI,which had AUCs of 0. 79 and 0. 87,respectively; FIB- 4 index had the worst diagnostic performance,with AUCs of 0. 77 and 0. 84,respectively. In patients with a fibrosis stage of > or =S2 or S4,Fibro Touch had a better diagnostic value than APRI and FIB- 4( Z = 21. 589,P < 0. 001; Z = 18. 896,P < 0. 001; Z = 11. 192,P = 0. 001; Z = 16. 891,P < 0. 001),and APRI had a better diagnostic value than FIB- 4( Z = 46. 918,P < 0. 001; Z = 35. 334,P < 0. 001). Conclusion Fibro Touch can accurately evaluate the presence of liver fibrosis and fibrosis degree and help most patients avoid invasive liver biopsy.