Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis B-related fibrosis: a leading meta-analysis.
Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis B-related fibrosis: a leading meta-analysis.
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DOI：
10.1186/1471-230x-12-14
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发表时间：
2012-02-14
影响因子：
2.4
通讯作者：
Xuan S
中科院分区：
文献类型：
--
作者：
Jin W;Lin Z;Xin Y;Jiang X;Dong Q;Xuan S
天冬氨酸转氨酶与血小板比率指数（APRI）是一种费用有限且广泛可用的工具，是检测肝纤维化的一种有前途的非侵入性肝活检替代方法。本研究的目的是系统地回顾APRI在预测乙型肝炎相关纤维化中的显著纤维化和肝硬化方面的表现。应用受试者工作特征曲线（AUROC）下面积、敏感性和特异性检验APRI诊断乙型肝炎相关显著纤维化和肝硬化的准确性。使用荟萃回归探索异质性。本荟萃分析纳入了9项研究（n = 1，798）。显著纤维化和肝硬化的患病率分别为53.1%和13.5%。显著纤维化和肝硬化的APRI的汇总AUC分别为0.79和0.75。对于严重的纤维化，APRI阈值为0.5是84%的敏感性和41%的特异性。在临界值1.5时，总的敏感性和特异性分别为49%和84%。对于肝硬化，APRI阈值为1.0-1.5的敏感性为54%，特异性为78%。在临界值2.0时，总体敏感性和特异性分别为28%和87%。Meta回归分析表明，APRI诊断肝纤维化和肝硬化的准确性受组织学分类系统的影响，但不受活检与APRI之间的间隔或盲检的影响。我们的荟萃分析表明，APRI在识别乙型肝炎相关的显著纤维化和肝硬化方面的价值有限。
The 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. Areas 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. Nine 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. Our meta-analysis suggests that APRI show limited value in identifying hepatitis B-related significant fibrosis and cirrhosis.