A Novel Non-invasive Model Based on GPR for the Prediction of Liver Fibrosis in Patients With Chronic Hepatitis B

Rongrong Ding; Wei Lu; Xinlan Zhou; Dan Huang; Yanbing Wang; Xiufen Li; Li Yan; Weijia Lin; Shu Song; Zhanqing Zhang; Liang Chen

doi:10.3389/fmed.2021.727706

A Novel Non-invasive Model Based on GPR for the Prediction of Liver Fibrosis in Patients With Chronic Hepatitis B

Front Med (Lausanne). 2021 Sep 23:8:727706. doi: 10.3389/fmed.2021.727706. eCollection 2021.

Authors

Rongrong Ding¹, Wei Lu¹, Xinlan Zhou¹, Dan Huang¹, Yanbing Wang¹, Xiufen Li¹, Li Yan¹, Weijia Lin¹, Shu Song², Zhanqing Zhang¹, Liang Chen³

Affiliations

¹ Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
² Department of Pathology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
³ Department of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.

Abstract

Background: Some controversy remains regarding conventional serum indices for the evaluation of liver fibrosis. Therefore, we aimed to combine the existing index with other serum parameters to discriminate liver fibrosis stages in patients with chronic hepatitis B (CHB). Methods: A total of 1,622 treatment-naïve CHB patients were divided into training (n = 1,211) and validation (n = 451) cohorts. Liver histology was assessed according to the Scheuer scoring scheme. All common demographic and clinical parameters were analyzed. Results: By utilizing the results of the logistic regression analysis, we developed a novel index, the product of GPR, international normalized ratio (INR), and type IV collagen (GIVPR), to discriminate liver fibrosis. In the training group, the areas under the ROCs (AUROCs) of GIVPR, APRI, FIB-4, and GPR for significant fibrosis were 0.81, 0.75, 0.72, and 0.77, respectively; the AUROCs of GIVPR, APRI, FIB-4, and GPR for advanced fibrosis were 0.82, 0.74, 0.74, and 0.78, respectively; and the AUROCs of GIVPR, APRI, FIB-4, and GPR for cirrhosis were 0.87, 0.78, 0.78, and 0.83, respectively. Similar results were also obtained in the validation group. Furthermore, the decision curve analysis suggested that GIVPR represented superior clinical benefits in both independent cohorts. Conclusion: The GIVPR constructed on GPR represents a superior predictive model for discriminating liver fibrosis in CHB patients.

Keywords: CHB; GPR; INR; liver fibrosis; type IV collagen.