LIVER FIBROSIS IN PATIENTS WITH CHRONIC LIVER DISEASES: ARE LABORATORY TESTS USEFUL TO DIAGNOSIS? (LETTER TO EDITOR)

摘要

The article published in Hepatitis Monthy on noninvasive assessment of liver fibrosis with the aspartate transaminasis to platelet ratio index (APRI) in patients with chronic liver disease by Yilmazet al. (1), is interesting and very useful to permit a diagnosis and staging of fibrosis, although this index does not seem to have a high sensitivity and specificity. In recent years, efforts have been made to develop non-invasive predictive models that may correlate with stage of fibrosis. One of the first non-invasive predictive models for patients with chronic hepatitis C (CHC) was the Fibrotest, which includes a 2-macroglobulin, haptoglobin, g -glutamil-transferase (GGT), apolipoprotein A1 and total bilirubin. However, considerable expenses and use of uncommon parameters reduce their clinical applicability. A few years later, the Forns’ score (age, GGT, cholesterol, platelets and prothrombin) and the APRI index (AST and platelets) overcame these draw-backs by use of only standard laboratory tests in the development of their predictive models.