Validation of Ten Noninvasive Diagnostic Models for Prediction of Liver Fibrosis in Patients with Chronic Hepatitis B

Jieyao Cheng; Jinlin Hou; Huiguo Ding; Guofeng Chen; Qing Xie; Yuming Wang; Minde Zeng; Xiaojuan Ou; Hong Ma; Jidong Jia

doi:10.1371/journal.pone.0144425

Validation of Ten Noninvasive Diagnostic Models for Prediction of Liver Fibrosis in Patients with Chronic Hepatitis B

PLoS One. 2015 Dec 28;10(12):e0144425. doi: 10.1371/journal.pone.0144425. eCollection 2015.

Authors

Jieyao Cheng¹, Jinlin Hou², Huiguo Ding³, Guofeng Chen⁴, Qing Xie⁵, Yuming Wang⁶, Minde Zeng⁷, Xiaojuan Ou¹, Hong Ma¹, Jidong Jia¹

Affiliations

¹ Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis & National Clinical Research Center of Digestive Diseases, Beijing, China.
² Hepatology Department, Nanfang Hospital, Southern Medical University, Guangzhou, China.
³ Gastroenterology and Hepatology Department, Beijing Youan Hospital, Capital Medical University, Beijing, China.
⁴ Diagnosis and Treatment Center of Liver Fibrosis, 302 Hospital of the China, Beijing, China.
⁵ Infectious Diseases Department, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China.
⁶ Infectious Diseases Department, Southwest Hospital, Third Military Medical University, Chongqing, China.
⁷ Gastroenterology Department, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China.

Abstract

Background and aims: Noninvasive models have been developed for fibrosis assessment in patients with chronic hepatitis B. However, the sensitivity, specificity and diagnostic accuracy in evaluating liver fibrosis of these methods have not been validated and compared in the same group of patients. The aim of this study was to verify the diagnostic performance and reproducibility of ten reported noninvasive models in a large cohort of Asian CHB patients.

Methods: The diagnostic performance of ten noninvasive models (HALF index, FibroScan, S index, Zeng model, Youyi model, Hui model, APAG, APRI, FIB-4 and FibroTest) was assessed against the liver histology by ROC curve analysis in CHB patients. The reproducibility of the ten models were evaluated by recalculating the diagnostic values at the given cut-off values defined by the original studies.

Results: Six models (HALF index, FibroScan, Zeng model, Youyi model, S index and FibroTest) had AUROCs higher than 0.70 in predicting any fibrosis stage and 2 of them had best diagnostic performance with AUROCs to predict F≥2, F≥3 and F4 being 0.83, 0.89 and 0.89 for HALF index, 0.82, 0.87 and 0.87 for FibroScan, respectively. Four models (HALF index, FibroScan, Zeng model and Youyi model) showed good diagnostic values at given cut-offs.

Conclusions: HALF index, FibroScan, Zeng model, Youyi model, S index and FibroTest show a good diagnostic performance and all of them, except S index and FibroTest, have good reproducibility for evaluating liver fibrosis in CHB patients.

Registration number: ChiCTR-DCS-07000039.

Publication types

Research Support, Non-U.S. Gov't
Validation Study

MeSH terms

Adult
Aspartate Aminotransferases / analysis
Biopsy / methods
Elasticity Imaging Techniques / methods
Female
Hepatitis B Surface Antigens / metabolism
Hepatitis B, Chronic / diagnosis*
Humans
Liver / pathology*
Liver / surgery
Liver Cirrhosis / diagnosis*
Male
Reproducibility of Results

Substances

Hepatitis B Surface Antigens
Aspartate Aminotransferases

Associated data

ChiCTR/CHICTR-DCS-07000039

Grants and funding

JYC received the funding from Wang Bao-En Liver Fibrosis Fund (an unrestricted grant from China Foundation for Hepatitis Prevention and Control, ChiCTR-DCS-07000039), Major Science and Technology Special Project of China Twelfth Five-year Plan (2012ZX10002003) and Key Project from Beijing Municipal Science and Technology Commission (Z09050700940902, D121100003912002, D121100003912003) in study design and data collection.