Nisan 2020
Hepatit C enfeksiyonunda karaciger histopatolojik evreleri ile albümin-bilirübin skoru arasindaki iliski
The relationship between histopathological stages of liver fibrosis and albumin–bilirubin score in chronic hepatitis C infection
- Ana Sayfa
- Sayılar
- Nisan 2020
- Hepatit C enfeksiyonunda karaciger histopatolojik evreleri ile albümin-bilirübin skoru arasindaki iliski...
Saglik Bilimleri Üniversitesi, Gülhane Tip Fakültesi, 3Tibbi Mikrobiyoloji Anabilim Dali, 4Tibbi Patoloji Anabilim Dali, 5Gastroenteroloji Bilim Dali, Ankara
Özet
Giris ve Amaç: Karaciger fibrozunu degerlendirmek için birçok invazivolmayan biyokimyasal indeksler gelistirilmistir. Bu çalismada allbümin-bilirübin skorunun kronik hepatit C virüs enfeksiyonunda gelisen karacigerfibrozunun tahmininde karaciger biyopsisine alternatif bir tani yöntemiolup olamayacaginin degerlendirilmesi ve diger biyokimyasal belirteçlerolan fibrozis-4 ve aspartat aminotransferaz/trombosit oran indeksi ilekarsilastirilmasi amaçlanmistir. Gereç ve Yöntem: Yas araligi 20 ile 82arasinda degisen, karaciger biyopsisi yapilmis, 27’si erkek ve 11’i kadintoplam 38 kronik hepatit C virüs enfeksiyonlu hasta degerlendirildi. Albümin-bilirübin, fibrozis-4 ve aspartat aminotransferaz/trombosit oranindeks skorlari hesaplandi. Albümin-bilirübin skorunun fibrozis evre >2ve ?4’ü ayirt etme yetenegi ROC analizi ile degerlendirildi ve fibrozis-4ve aspartat aminotransferaz/trombosit oran indeks skoru ile karsilasti-rildi. Bulgular: Albümin-bilirübin skorunun fibrozis evre >2 ve fibrozisevre ?4 tanisi için ROC egrisi altinda kalan alan sirasiyla 0.767 (95% Cl:0.564-0.969) ve 0.956 (95% Cl: 0.889-1.000) bulunurken, fibrozis-4 için0.863 (95% Cl: 0.714-1.000) ve 0.926 (95% Cl: 0.833-1.000), aspartat aminotransferaz/ trombosit oran indeks skoru için 0.667 (95% Cl:0.450-0.884) ve 0.640 (95% Cl: 0.378-0.901) idi. Sonuç: Bulgulara görealbümin-bilirübin skorunun fibrozis evre >2 ve ileri karaciger fibrozunu(fibrozis evre ?4) tahmin edebilecegi degerlendirilmistir. Albümin-bilirü-bin skorunun fibrozis tahminindeki performansi, aspartat aminotransferaz/trombosit oran indeks skoru ve fibrozis-4 ile karsilastirildiginda sonuçlarin benzer oldugu ancak fibrozis evre >2 tahmininde fibrozis-4’ün,fibrozis evre ?4’de ise aspartat aminotransferaz/ trombosit oran indeksskorunun daha güvenilir sonuç verdigi degerlendirilmistir
Abstract
Background and Aims: Many noninvasive biochemical indices havebeen developed to evaluate liver fibrosis. This study aimed to evaluatewhether albumin–bilirubin score might be used as an alternative diagnostic method to performing liver biopsy to help predict liver fibrosis developing in patients with chronic hepatitis C virus infection and comparethe score with other biochemical markers, for example, fibrosis-4 andaspartate aminotransferase-to-platelet ratio index (APRI) scores. Material and Methods: A total of 38 patients between the ages of 20 and 82who had chronic hepatitis C virus infection and who underwent liver biopsy were evaluated. The patients were 27 males and 11 females. Albumin–bilirubin score, fibrosis-4, and aspartate aminotransferase-to-platelet ratio index score were calculated. Whether albumin–bilirubin scorecould differentiate fibrosis stage >2 from fibrosis stage ?4 was evaluated by ROC analysis, and the score was compared with fibrosis-4 andaspartate aminotransferase-to-platelet ratio index scores. Results: Theareas under the ROC curve for predicting fibrosis stage >2 and advancedliver fibrosis (fibrosis stage ?4) according to the albumin–bilirubin scorewere 0.767 (95% Cl: 0.564–0.969) and 0.956 (95% Cl: 0.889–1.000),respectively, while they were 0.863 (95% Cl: 0.714–1.000) and 0.926(95% Cl: 0.833–1.000) according to fibrosis-4 score and 0.667 (95% Cl:0.450–0.884) and 0.640 (95% Cl: 0.378–0.901) according to aspartateaminotransferase-to-platelet ratio index score. Conclusions: Accordingto the findings, it was concluded that albumin–bilirubin score couldpredict fibrosis stage >2 and advanced liver fibrosis (fibrosis stage ?4).When the performance of albumin–bilirubin score in the prediction of fibrosis was compared with that of aspartate aminotransferase-to-plateletratio index index and fibrosis-4 scores, the results were similar. However,fibrosis-4 score gave more reliable results in the prediction of fibrosisstage >2, while albumin–bilirubin score gave more reliable results in theprediction of advanced liver fibrosis (fibrosis stage ?4)
