Non-ALT biomarkers for markedly abnormal liver histology among Chinese persistently normal alanine aminotransferase-chronic hepatitis B patients

作     者：Jin-Lin Cheng Xiao-Ling Wang Shi-Gui Yang Hong Zhao Jing-Jing Wu Lan-Juan Li 

作者机构：State Key Laboratory for the Diagnosis and Treatment of Infectious DiseasesCollaborative Innovation Centre for the Diagnosis and Treatment of Infectious DiseasesFirst Affiliated HospitalSchool of MedicineZhejiang University Department of PathologyFirst Affiliated HospitalSchool of MedicineZhejiang University Department of Infectious DiseasesFirst Affiliated HospitalSchool of MedicineZhejiang University 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2017年第23卷第15期

页      面：2802-2810页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：Supported by the National Science and Technology Major Project of China No.2012ZX10002004-001 

主　　题：Chronic hepatitis B Liver biopsy Normal alanine aminotransferase Necroinflammation Hepatic fibrosis 

摘      要：AIM To determine incidence and clinical biomarkers of marked necroinflammation and fibrosis characteristics among chronic hepatitis B (CHB) patients with persistently normal alanine aminotransferase (PNALT). METHODS Liver biopsy was performed on 115 CHB patients with PNALT. Necroinflammation and fibrosis were graded by the Knodell histologic activity index and the Ishak fibrosis score, respectively. Correlations between the available clinical parameters and necroinflammation and fibrosis were analysed. RESULTS Marked necroinflammation (Knodell activity index = 7) and fibrosis (Ishak fibrosis score = 3) were found in 36.5% and 15.5% of CHB patients with PNALT, respectively. Following a univariate logistic regression analysis, multiple logistic regression analysis indicated that aspartate transaminase (AST) (AUROC = 0.852, cut-off value = 22.5 U/L) serves as an independent predictor of notable liver inflammation, while platelet (PLT) count (AUROC = 0.905, cut-off value = 171.5 x 10(9)/ml) and gamma-glutamyl transpeptidase (GGT) (AUROC = 0.909, cut-off value = 21.5 U/L) level serve as independent predictors of notable liver fibrosis. CONCLUSION A considerable proportion of marked histological abnormalities existed in our cohort, who will benefit from optimal therapeutic strategies administered according to predictive indication by AST, PLT and GGT levels.