Hepatit B Enfeksiyonunda Karaciğer Histopatolojik Evreleri ile Albumin-Bilirubin Skoru Arasındaki İlişki

Yıl 2022, Cilt: 24 Sayı: 1, 60 - 66, 30.04.2022

Harun Erdal , Ayfer Bakır , Mustafa Güney , Armağan Günal , Mustafa Gülşen

https://doi.org/10.18678/dtfd.1055076

Öz

Amaç: Bu çalışmada albümin-bilirubin (ALBI) skorunun belirgin karaciğer fibrozisini saptamada duyarlılık ve özgüllüğü araştırıldı ve bu bulgular fibrozis-4 (FIB-4) ve aspartat aminotransferaz/trombosit oranı indeksi (aspartate aminotransferase to platelet ratio index, APRI) skorları ile karşılaştırıldı.
Gereç ve Yöntemler: Bu çalışmaya toplam 69 hasta dahil edildi. Hastaların 54’ü (%78,3) erkek ve 15’i (%21,7) kadın idi. Kronik hepatit B virüs (HBV) enfeksiyonu nedeniyle karaciğer biyopsi yapılan hastaların seroloji, moleküler analiz, biyokimyasal parametreler ve patoloji sonuçları retrospektif olarak değerlendirildi. ALBI, APRI ve FIB-4 skorları hesaplandı. Fibrozis evresi F≥2 ve F≥4'ü tahmin etmek için ALBI, APRI ve FIB-4 skorları, alıcı işlem karakteristiği (receiver operator characteristic, ROC) eğrisi analizi kullanılarak araştırıldı.
Bulgular: ALBI, APRI ve FIB-4 skorları için F≥2 tahmininde %95 güven aralığı (GA) ile ROC eğrisi altında kalan alan, sırasıyla, 0,613 (%95 GA: 0,463-0,762; p=0,160), 0,658 (%95 GA: 0,513-0,803; p=0.040) ve 0,731(%95 GA: 0,570-0,891; p=0,004) iken F≥4 tahmininde ise sırasıyla, 0,758 (%95 GA: 0,544-0,971; p=0,090), 0,604 (%95 GA: 0,451-0,757; p=0,490) ve 0,923 (%95 GA: 0,856-0,990; p=0,005) idi. ALBI skoru için duyarlılık ve özgüllük değerleri F≥2 tahmininde -2.81 kesim değeri için sırasıyla, %61,1 ve %64,7 iken F≥4 tahmininde -2.78 kesim değeri için sırasıyla, %75,0 ve %70,8 idi.
Sonuç: Kronik HBV’li hastalarda F≥2’yi belirlemek için ALBI skoru kullanılabilir. Ancak, bu yaklaşımın F≥4'ü saptamak için diğer invaziv olmayan yöntemlerden üstün olup olmadığı henüz açık değildir.

Anahtar Kelimeler

Hepatit B, kronik, biyopsi, fibrozis

Relationship between Histopathological Stages of Liver and Albumin-Bilirubin Score in Hepatitis B Infection

Öz

Aim: In this study, sensitivity and specificity of the albumin-bilirubin (ALBI) score were investigated to detect significant liver fibrosis, and these findings were then compared to fibrosis-4 (FIB-4) and aspartate aminotransferase to platelet ratio index (APRI) scores.
Material and Methods: A total of 69 patients were included in the study. Of these patients, 54 (78.3%) were male and 15 (21.7%) were female. Serology, molecular analysis, biochemical parameters, and pathology results of the patients who underwent a liver biopsy due to a chronic hepatitis B virus (HBV) infection, were retrospectively evaluated. ALBI, APRI, and FIB-4 scores were calculated. To predict the fibrosis stage, F≥2 and F≥4, ALBI, APRI, and FIB-4 scores were investigated using the receiver operator characteristic (ROC) curve analysis.
Results: The area under the ROC curve with 95% confidence interval (CI) for the ALBI, APRI, and FIB-4 scores were 0.613 (95% CI: 0.463-0.762, p=0.160), 0.658 (95% CI: 0.513-0.803, p=0.040), and 0.731 (95% CI: 0.570-0.891, p=0.004), respectively, to predict the F≥2, and 0.758 (95% CI: 0.544-0.971, p=0.090), 0.604 (95% CI:0.451-0.757, p=0.490), and 0.923 (95% CI: 0.856-0.990, p=0.005), respectively, in prediction of F≥4. The sensitivity and specificity rates of the ALBI score were 61.1% and 64.7%, respectively, for the cut-off value of -2.81 in predicting F≥2, and 75.0% and 70.8% for the cut-off value of -2.78 in predicting F≥4.
Conclusion: ALBI scores can be used to detect F≥2 in patients with chronic HBV. However, it is not yet clear whether this approach is superior to other non-invasive methods for detecting F≥4.

Anahtar Kelimeler

Hepatitis B, chronic, biopsy, fibrosis

Kaynakça

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