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A Novel Prediction Model for Significant Liver Fibrosis in Patients with Chronic Hepatitis B
- Source :
- BioMed Research International, BioMed Research International, Vol 2020 (2020)
- Publication Year :
- 2020
- Publisher :
- Hindawi, 2020.
-
Abstract
- Background. Preventing liver fibrosis from progressing to cirrhosis and even liver cancer is a key step in the treatment of chronic hepatitis B (CHB). This study is aimed at constructing and validating a new nomogram for predicting significant liver fibrosis (S≥2) in CHB patients. Methods. The nomogram was based on a retrospective study of 252 CHB patients. The predictive accuracy and discriminative ability of the nomogram were evaluated by the area under receiver operating characteristic curve (AUROC), decision curves, and calibration curve compared with the fibrosis 4 score (FIB-4) and aspartate aminotransferase-to-platelet ratio index (APRI). The results were validated using bootstrap resampling and an external set of 168 CHB patients. Results. A total of 420 CHB patients were enrolled based on liver biopsy results. Independent factors predicting significant liver fibrosis were laminin (LN), procollagen type III N-terminal peptide (PIIINP), and blood platelet count (PLT) in a multivariate analysis, and these factors were selected to construct the nomogram. The calibration curve for the probability of significant liver fibrosis showed optimal agreement between the prediction from the nomogram and actual observation. The prediction from the nomogram was more consistent with the results of liver biopsy than FIB-4 and APRI. The AUROC of the nomogram was higher than that of FIB-4 and APRI for predicting significant liver fibrosis. These results were confirmed in the validation set. Furthermore, the decision curve analysis suggested that the most net benefits were provided by the nomogram. Conclusions. We found the proposed nomogram resulted in a more accurate prediction of significant liver fibrosis in CHB patients and could provide the most net benefits. We recommend this noninvasive assessment for patients with liver fibrosis to avoid the risk of liver biopsy and earlier intervention to prevent the development of cirrhosis or liver cancer.
- Subjects :
- Adult
Liver Cirrhosis
medicine.medical_specialty
Cirrhosis
Article Subject
genetic structures
urologic and male genital diseases
Gastroenterology
Models, Biological
General Biochemistry, Genetics and Molecular Biology
03 medical and health sciences
0302 clinical medicine
Hepatitis B, Chronic
Fibrosis
Internal medicine
medicine
Humans
General Immunology and Microbiology
medicine.diagnostic_test
Receiver operating characteristic
business.industry
Reproducibility of Results
Retrospective cohort study
General Medicine
Hepatitis B
Nomogram
medicine.disease
Nomograms
Logistic Models
ROC Curve
030220 oncology & carcinogenesis
Liver biopsy
Calibration
Multivariate Analysis
Medicine
030211 gastroenterology & hepatology
Female
Liver cancer
business
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 23146141 and 23146133
- Volume :
- 2020
- Database :
- OpenAIRE
- Journal :
- BioMed Research International
- Accession number :
- edsair.doi.dedup.....0bf9b1a926a04367dbab92a3f43815e5