Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis B-related fibrosis: a leading meta-analysis

BMC Gastroenterology

Research Article

Yongning Xin¹  Shiying Xuan¹  Zhonghua Lin²  Wenwen Jin²  Quanjiang Dong²  Xiangjun Jiang² 

[1]Qingdao Municipal Hospital, 266021, Qingdao, Shandong Province, China

[2]College of Medicine and Pharmaceutics, Ocean University of China, 266003, Qingdao, Shandong Province, China

[3]Qingdao City Key Laboratory of Digestive Diseases, 266021, Qingdao, China

[4]Qingdao Municipal Hospital, 266021, Qingdao, Shandong Province, China

[5]Qingdao City Key Laboratory of Digestive Diseases, 266021, Qingdao, China

关键词: APRI;    HBV;    liver fibrosis;    diagnostic accuracy;    meta-analysis;   

DOI  :  10.1186/1471-230X-12-14

 received in 2011-08-14, accepted in 2012-02-14,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThe aspartate aminotransferase-to-platelet ratio index (APRI), a tool with limited expense and widespread availability, is a promising noninvasive alternative to liver biopsy for detecting hepatic fibrosis. The objective of this study was to systematically review the performance of the APRI in predicting significant fibrosis and cirrhosis in hepatitis B-related fibrosis.MethodsAreas under summary receiver operating characteristic curves (AUROC), sensitivity and specificity were used to examine the accuracy of the APRI for the diagnosis of hepatitis B-related significant fibrosis and cirrhosis. Heterogeneity was explored using meta-regression.ResultsNine studies were included in this meta-analysis (n = 1,798). Prevalence of significant fibrosis and cirrhosis were 53.1% and 13.5%, respectively. The summary AUCs of the APRI for significant fibrosis and cirrhosis were 0.79 and 0.75, respectively. For significant fibrosis, an APRI threshold of 0.5 was 84% sensitive and 41% specific. At the cutoff of 1.5, the summary sensitivity and specificity were 49% and 84%, respectively. For cirrhosis, an APRI threshold of 1.0-1.5 was 54% sensitive and 78% specific. At the cutoff of 2.0, the summary sensitivity and specificity were 28% and 87%, respectively. Meta-regression analysis indicated that the APRI accuracy for both significant fibrosis and cirrhosis was affected by histological classification systems, but not influenced by the interval between Biopsy & APRI or blind biopsy.ConclusionOur meta-analysis suggests that APRI show limited value in identifying hepatitis B-related significant fibrosis and cirrhosis.

【 授权许可】

Unknown   
© Jin et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.