Oncotarget

Research Papers:

Impact of age on the diagnostic performances and cut-offs of APRI and FIB-4 for significant fibrosis and cirrhosis in chronic hepatitis B

Qiang Li, Chuan Lu, Weixia Li, Yuxian Huang and Liang Chen _

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Oncotarget. 2017; 8:45768-45776. https://doi.org/10.18632/oncotarget.17470

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Abstract

Qiang Li1,2, Chuan Lu1, Weixia Li1, Yuxian Huang1,2 and Liang Chen1

1Department of Hepatitis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China

2Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China

Correspondence to:

Liang Chen, email: [email protected]

Qiang Li, email: [email protected]

Keywords: chronic hepatitis B, liver fibrosis, cirrhosis, noninvasive marker, influence factors

Received: March 08, 2017    Accepted: April 15, 2017    Published: April 27, 2017

ABSTRACT

Aims: Assessing the diagnostic performances of APRI and FIB-4 using age as a categorical marker.

Methods: 822 chronic hepatitis B (CHB) patients were included. Using METAVIR scoring system as a reference, the performances of APRI and FIB-4 were compared between patients aged≥30 and patients aged<30 years.

Results: The APRI AUROC in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (0.61 vs 0.70, p<0.001) and cirrhosis (0.64 vs 0.78, p<0.001). The FIB-4 AUROC in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (0.57 vs 0.65, p<0.001) and cirrhosis (0.63 vs 0.72, p<0.001). Using specificity≥90%, the APRI cut-off in patients aged<30 years was lower than patients aged≥30 years for significant fibrosis (1.0 vs 1.2) and cirrhosis (1.2 vs 1.5). Using sensitivity≥90%, the APRI cut-off in patients aged<30 years was also lower than patients aged≥30 years for significant fibrosis (0.2 vs 0.4) and cirrhosis (0.3 vs 0.5). Using specificity≥90%, the FIB-4 cut-off in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (1.2 vs 2.1) and cirrhosis (1.4 vs 2.6). Using sensitivity≥90%, the FIB-4 cut-off in patients aged<30 years was also lower than that in patients aged≥30 years for significant fibrosis (0.5 vs 0.8) and cirrhosis (0.8 vs 1.2).

Conclusions: Evaluation of the diagnostic performances of APRI and FIB-4 should take age into consideration.


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