NGHIÊN CỨU PHỐI HỢP TỶ SỐ GPR VÀ APRI TRONG ĐÁNH GIÁ XƠ HÓA GAN Ở BỆNH NHÂN VIÊM GAN VIRUS B MẠN TÍNH

Abstract

Background: Liver fibrosis assessment is an important step in chronic hepatitis B (CHB) management. Although the Acoustic Radiation Force Impulse (ARFI) has been widely used and has reduced the need for liver biopsy, it still has been available only in center hospitals. Therefore, inexpensive non-invasive fibrosis tests are highly important but have been poorly studied in Viet Nam.

Objectives: Investigation of GPR and APRI ratio in patients with chronic hepatitis B virus. Comparison of the combined value of the GPR ratio and the APRI index with the APRI index in the ARFI-based assessment of liver fibrosis in these patients.

Methods: A cross-sectional descriptive study analysis on 79 patients ≥ 18 years old, diagnosed with chronic hepatitis B virus, examined at Hue University of Medicine and Pharmacy Hospital and Phu Vang District Health Center from 5/2021 to 9/2022 . GPR, APRI were calculated based on routine liver function tests and 79 patients were all measured liver fibrosis by ARFI technique at Hue Medic Medical Center.

Results: In the assessment of significant fibrosis: with a cutoff value of 0.397; APRI has quite good accuracy in diagnosing significant fibrosis (AUROC: 0.725), sensitivity 74.3%; specificity 70.5%; PPV 65%; NPV 76.9%, but when combined with GPR ratio, accuracy increased to 0.942; sensitivity and NPV increased to 100%; specificity increased to 85.1%; PPV increased to 82.1%. For advanced fibrosis: With a cutoff of 0.406; APRI has an accuracy of 0.799; sensitivity 86.7%; specificity 62.5%; PPV 35.1%; NPV 95.2% and when combined with GPR ratio, the accuracy increases to 0.882; sensitivity, NPV also increased to 100%.

Conclusions: The combination of GPR ratio and APRI index increased the accuracy, sensitivity, specificity, and predictive values compared with using each index alone in the assessment of liver significant fibrosis and advanced fibrosis.