Author/Authors :
Arslan Fatma Demet نويسنده Department of Medical Biochemistry, Tepecik Training and Research Hospital, Izmir, Turkey , Köse Sukran نويسنده Department of Infectious Diseases and Clinical
Microbiology, Tepecik Training and Research Hospital, Izmir,
Turkey , Karakoyun Inanc نويسنده Department of Medical Biochemistry, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey , Tatar Bengu نويسنده Clinic of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey , Pala Emel Ebru نويسنده Department of Medical Pathology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey , Yıldırım Mustafa نويسنده Clinic of Internal Medicine, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey , Ulasoglu Celal نويسنده Clinic of Gastroenterology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey , Duman Can نويسنده Department of Medical Biochemistry, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey , Akar Harun نويسنده Clinic of Internal Medicine, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey , Isbilen Basok Banu نويسنده Department of Medical Biochemistry, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
Abstract :
[Background]This study aimed at creating a new predictive model of significant fibrosis in chronic hepatitis B using direct and indirect parameters and comparing this model with other noninvasive models for its validation in clinical settings.[Methods]Patients (n = 81), according to the ISHAK score, were classified as mild and significant fibrosis. Serum matrix metalloproteinase-2, tissue inhibitor of metalloproteinase-2, beta-nerve growth factor levels, and indirect parameters were analyzed. To evaluate the presence of significant hepatic fibrosis, well-known conventional models were also evaluated. The cut-off values of each model were determined using receiver operating characteristic curves to distinguish patients with mild and significant fibrosis.[Results]Significant hepatic fibrosis index-1 was constructed using the following equation: (matrix metalloproteinase-2 × age × prothrombin time × direct bilirubin) / (albumin × platelet). The sensitivity and specificity for significant hepatic fibrosis index-1 were 73.3% and 95.6%, respectively. Area under the curve of significant hepatic fibrosis index-1 was 0.895 (P < 0.001), which was higher than the other models. Due to limitations of matrix metalloproteinase-2, significant hepatic fibrosis index-2 was constructed using a formula without matrix metalloproteinase-2. However, there were no significant differences between significant hepatic fibrosis index-1 and significant hepatic fibrosis index-2 or other models, except for 3 models.[Conclusions]Significant hepatic fibrosis index-1 employs a new marker; matrix metalloproteinase-2 along with routine parameters had the best diagnostic performance for significant fibrosis in patients with chronic hepatitis B. Using significant hepatic fibrosis index-1 or even significant hepatic fibrosis index-2 might be an alternative approach in place of liver biopsy to predict significant fibrosis in chronic hepatitis B cohort.
