Kronik hepatit B'de hemogram ve biyokimyasal parametrelerin modifiye histolojik aktivite indeksi ve hepatik fibrozis ile ilişkisi

Yıl 2021, Cilt: 46 Sayı: 3, 1237 - 1244, 30.09.2021

Selma Erdoğan Düzcü , Şeyma Öztürk

Öz

Amaç: Kronik hepatit B sirozun ve hepatosellüler karsinomun önemli nedenlerinden biri olup karaciğer biopsisi fibrozis tanısında altın standart yöntemdir. Karaciğer biopsilerinin histolojik değerlendirilmesinde noninvaziv prediktif faktörlere ihtiyaç vardır. Bu çalışmada kronik hepatit B vakalarında modifiye histolojik aktivite indeksi ve fibrozis için hemogram ve biyokimyasal markerların diagnostic value araştırılması amaçlanmıştır.
Gereç ve Yöntem: Bu çalışmada kronik hepatit B tanılı 248 hastaya ait karaciğer trucut biopsileri retrospektif olarak değerlendirilmiştir. Modifiye histolojik aktivite ve fibrozis skoru Ishak sınıflaması dikkate alınarak yapılmış olup hemogram ve biyokimyasal markerlarla karşılaştırılmıştır.
Bulgular: Fibrozis < 3 ve ≥3 gruplarını en iyi ayırt eden biyobelirteç %70.3 ayırt etme performansı ile aspartat aminotransferaz (AST) değeriydi. Histolojik aktivite indeksinde <6 ve ≥6 gruplarını en iyi ayırt eden biyobelirteçler, %75.5 ayırt etme performansı ile AST ve %73.7 ile alanine aminotransferaz (ALT) ve %73.4 ile gama-glutamil-transferaz değerleriydi.
Sonuç: Çalışmamızda kronik hepatit B vakalarında klinik pratikte kullanılan girişimsel olmayan markerların fibrozis ve nekroinflamatuar aktivitesini tahminde tanısal değere sahip olduğu gösterilmiştir.

Anahtar Kelimeler

Kronik B hepatiti, histolojik aktivite indeksi, karaciğer fibrozisi, tam kan sayımı, biyokimya

Relationship of hemogram and biochemical parameters with modified histologic activity index and hepatic fibrosis in chronic hepatitis B

Öz

Purpose: Chronic hepatitis B is still one of the leading causes of cirrhosis and hepatocellular carcinoma worldwide, and the liver biopsy the gold standard method to assess the severity of liver fibrosis. Noninvasive predictive factors are needed for histological evaluation of liver biopsies. In this study, it was aimed to investigate the diagnostic value of hemogram and biochemical parameters for modified histological activity index and fibrosis in patients with chronic hepatitis B.
Materials and Methods: In this study, liver tru-cut biopsies of 248 patients diagnosed with chronic hepatitis B, were evaluated retrospectively. Modified histological activity index and fibrosis were scored in accordance with the Ishak staging system and compared with hemogram and biochemical parameters.
Results: In the fibrosis groups, the aspartate aminotransferase (AST) value was the best marker to discriminate < 3 ve ≥3 groups, with 70,3% discrimination performance. In the histological activity index groups, AST, alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT) was the best parameters to discriminate <6 ve ≥6 groups with 75,5%, 73,7%, and 73,4% discrimination performances, respectively.
Conclusion: In our study, we showed that noninvasive parameters used in clinical practice in patients with chronic hepatitis B have diagnostic value in predicting fibrosis and necroinflammatory activity.

Anahtar Kelimeler

Chronic hepatitis B, histological activity index, liver fibrosis, complete blood count, biochemistry

Kaynakça

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