Table 3.
Diagnostic performance of serum markers for liver fibrosis in patients with CHB
| Cross-sectional study | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Serum marker | Reference | No. of patients | Nation | Significant fibrosis (≥F2) |
Advanced fibrosis (≥F3) |
Cirrhosis (F4) |
|||||||||
| No. of patients (%) | AUC (95% CI) | Cutoff value | Sensitivity%/specificity% | No. of patients (%) | AUC (95% CI) | Cutoff value | Sensitivity%/specificity% | No. of patients (%) | AUC (95% CI) | Cutoff value | Sensitivity%/specificity% | ||||
| FIB-4 | Zhu et al. [104] (2011) | 175 | China | 79 (45.1) | 0.86 (0.80–0.91) | 1.7 | 74.0/84.0 | - | - | - | - | 29 (16.6) | 0.77 (0.68–0.85) | 1.0 | 69.0/75.0 |
| APRI | Sebastiani et al. [103] (2011) | 253 | Italy | 146 (57.7) | 0.69 (0.63–0.76) | 1.5 | 37.0/98.0 | - | - | - | - | 45 (17.8) | 0.66 (0.60–0.71) | 2.0 | 20.6/83.6 |
| Zhu et al. [104] (2011) | 175 | China | 79 (45.1) | 0.81 (0.74–0.87) | 0.5 | 82.0/83.0 | - | - | - | - | 29 (16.6) | 0.83 (0.77–0.90) | 1.0 | 76.0/69.0 | |
| Fibro-Test | Sebastiani et al. [103] (2011) | 253 | Italy | 146 (57.7) | 0.69 (0.63–0.75) | 0.48 | 54.0/83.0 | - | - | - | - | 45 (17.8) | 0.93 (0.82–0.98) | 0.75 | 42.0/91.0 |
| Kim et al. [106] (2012) | 194 | Korea | 164 (84.5) | 0.90 (0.84–0.97) | 0.32 | 79.0/83.0 | 114 (58.8) | 0.91 (0.86–0.95) | 0.52 | 86.0/90.0 | 75 (38.7) | 0.87 (0.82–0.92) | 0.68 | 80.0/84.0 | |
|
Meta-analysis
| |||||||||||||||
| Serum marker | Reference | No. of patients | No. of studies |
Significant fibrosis (≥F2)
|
Advanced fibrosis (≥F3)
|
Cirrhosis (F4)
|
|||||||||
| No. of studies (patients) | AUC (95% CI) | Cutoff value | Sensitivity%/specificity% | No. of studies (patients) | AUC (95% CI) | Cutoff value | Sensitivity%/specificity% | No. of studies (patients) | AUC (95% CI) | Cutoff value | Sensitivity%/specificity% | ||||
| FIB-4 | Xiao et al. [102] (2015) | 6,513 | 23 | 22 (6,455) | 0.76 (0.69–0.87) | 3.25 | 16.2/95.2 | 22 (6,338) | 0.80 (0.74–0.91) | 3.25 | 17.0/98.0 | 19 (6,068) | 0.78 (0.71–0.93) | 1.63–2.65 | 64.3/85.5 |
| APRI | Xiao et al. [102] (2015) | 9,080 | 37 | 34 (8,855) | 0.72 (0.61–0.88) | 1.5 | 34.1/89.5 | 33 (8,254) | 0.76 (0.68–0.87) | 1.5 | 33.0/91.0 | 34 (8,773) | 0.72 (0.50–0.85) | 1.5 | 36.9/92.5 |
| Fibro-Test | Salkic et al. [107] (2014) | 4,248 | 16 | 16 (2,494) | 0.78 | 0.48 | 62.0/79.0 | - | - | - | - | 13 (1,754) | 0.87 | 0.74 | 62.0/91.0 |
CHB, chronic hepatitis B; FIB-4, fibrosis-4 index; APRI, aspartate aminotransferase-to-platelet ratio index; AUC, area under the curve; CI, confidence interval.