Evaluation of Aspartate Aminotransferase-to-Platelet Ratio Index as a Non-Invasive Marker for Liver Cirrhosis

Princi Jain; B K Tripathi; B Gupta; Bharti Bhandari; Divesh Jalan

doi:10.7860/JCDR/2015/13944.6814

Evaluation of Aspartate Aminotransferase-to-Platelet Ratio Index as a Non-Invasive Marker for Liver Cirrhosis

J Clin Diagn Res. 2015 Nov;9(11):OC22-4. doi: 10.7860/JCDR/2015/13944.6814. Epub 2015 Nov 1.

Authors

Princi Jain¹, B K Tripathi², B Gupta³, Bharti Bhandari⁴, Divesh Jalan⁵

Affiliations

¹ Ex Resident, Department of Medicine, VMMC & SJH , New Delhi, India .
² Professor, Department of Medicine, VMMC & SJH , New Delhi, India .
³ Ex Professor and Head, Department of Medicine, VMMC & SJH , New Delhi, India .
⁴ Assistant Professor, Department of Physiology, AIIMS , Jodhpur, India .
⁵ Assistant Professor, Department of Orthopaedics, AIIMS , Jodhpur, India .

Abstract

Introduction: Liver biopsy is considered as a gold standard for the diagnosis of cirrhosis. Till date there is no non-invasive marker to replace it.

Aim: To investigate the effectiveness of Aspartate aminotransferase-to-platelet ratio index (APRI) as a non-invasive marker for liver cirrhosis.

Materials and methods: Fifty-one patients with cirrhosis, identified on USG abdomen were included in study. Platelet count and Aspartate aminotransferase (AST) were done using haematology automatic analyser and automatic HITACHI-912 Auto Analyser respectively. APRI was calculated for every patient using the formula {(AST / ULN) x 100}/platelet count (10(9)/L). Predictive accuracy was evaluated with a receiver-operating characteristics (ROC) curve.

Results: APRI correctly classified 49 (96.1%) patients of cirrhosis with area under the ROC curve of 0.973 (95% CI) at cut-off 0.65 with negative predictive value (NPV) and Positive predictive value (PPV) of 96% and 96.1% respectively. The sensitivity and specificity of the test was found to be 96% and 96.1% respectively.

Conclusion: APRI could identify cirrhosis with high degree of accuracy in the studied patients.

Keywords: Cirrhosis; Liver enzymes; Platelet count.