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Prediction of significant fibrosis in chronic hepatitis C patients with normal ALT

Authors
 Park JJ  ;  Park JY  ;  Kim DY  ;  Park YN  ;  Ahn SH  ;  Chon CY  ;  Han KH 
Citation
 Hepato-Gastroenterology, Vol.58(109) : 1321-1327, 2011 
Journal Title
 Hepato-Gastroenterology 
ISSN
 0172-6390 
Issue Date
2011
MeSH
Adult ; Alanine Transaminase/blood* ; Female ; Hepatitis C, Chronic/complications* ; Hepatitis C, Chronic/physiopathology ; Humans ; Liver Cirrhosis/diagnosis* ; Male ; Middle Aged ; Prospective Studies
Abstract
BACKGROUND/AIMS : Prediction of significant fibrosis (F=2) using non-invasive methods for chronic hepatitis C (CHC) patients with persistently normal alanine aminotransferase (PNALT) levels remains a challenging problem. We aimed to develop a novel non-invasive model for predicting the presence of significant fibrosis in CHC patients with PNALT. METHODOLOGY : We prospectively enrolled 40 treatment-naïve CHC patients with PNALT who underwent liver biopsy and liver stiffness measurements (LSM). Age-platelet index (API), aspartate aminotransferase to platelet ratio index (APRI), LSM and LSM to platelet ratio index (LPRI) were compared with liver histology results. RESULTS : Significant fibrosis was diagnosed in 17 patients (42.5%). The diagnostic accuracy of LPRI was the highest for the prediction of significant fibrosis (AUROC = 0.859) when compared to that of APRI (0.770), LSM (0.769) and API (0.703). Using a cutoff value of LPRI =37, the significant fibrosis could be correctly identified with high accuracy (100% PPV) in 6 (15.0%) patients. While, using an LPRI cutoff value <20, it could be excluded with 94.1% NPV in 17 (42.5%) patients. Consequently, 57.5% of the CHC patients with PNALT levels could avoid liver biopsy. CONCLUSIONS : The LPRI was useful in predicting significant fibrosis. Screening CHC patients PNALT using LPRI has the potential to reduce the number of liver biopsies and might help designing appropriate management plans.
DOI
10.5754/hge11041
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
김도영(Kim, Do Young)
박영년(Park, Young Nyun) ORCID logo https://orcid.org/0000-0003-0357-7967
박재준(Park, Jae Jun)
박준용(Park, Jun Yong) ORCID logo https://orcid.org/0000-0001-6324-2224
안상훈(Ahn, Sang Hoon) ORCID logo https://orcid.org/0000-0002-3629-4624
전재윤(Chon, Chae Yoon)
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/158174
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