Development and Validation of a Nomogram to Predict Significant Liver Inflammation in Patients with Chronic Hepatitis B

列线图 医学 接收机工作特性 凝血酶原时间 肝活检 内科学 逻辑回归 胃肠病学 丙氨酸转氨酶 活检
作者
Suling Jiang,Jian Wang,Zhiyi Zhang,Jie Zhan,Ruifei Xue,Yuanwang Qiu,Liguo Zhu,S. Zhang,Yifan Pan,Xiaomin Yan,Yuxin Chen,Jie Liu,Xingxiang Liu,Chuanwu Zhu,Rui Huang,Chao Wu
出处
期刊:Infection and Drug Resistance [Dove Medical Press]
卷期号:Volume 16: 5065-5075
标识
DOI:10.2147/idr.s417007
摘要

Noninvasive diagnosis of liver inflammation is important for patients with chronic hepatitis B (CHB). This study aimed to develop a nomogram to predict significant liver inflammation for CHB patients.CHB patients who underwent liver biopsy were retrospectively collected and randomly divided into a development set and a validation set. The least absolute shrinkage and selection operator regression and logistic regression analysis were used to select independent predictors of significant liver inflammation, and a nomogram was developed. The performance of nomogram was assessed by receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA).A total of 1019 CHB patients with a median age of 39.0 years were included. Alanine aminotransaminase (ALT, P = 0.018), gamma-glutamyl transpeptidase (P = 0.013), prothrombin time (P < 0.001), and HBV DNA level (P = 0.030) were identified as independent predictors of significant liver inflammation in the development set. A model namely AGPD-nomogram was developed based on the above parameters. The area under the ROC curve in predicting significant inflammation was 0.765 (95% CI: 0.727-0.803) and 0.766 (95% CI: 0.711-0.821) in the development and validation sets, which were significantly higher than other indexes. The AGPD-nomogram had a high predictive value in patients with normal ALT. Moreover, the nomogram was proven to be clinically useful by DCA.A visualized AGPD-nomogram which incorporated routine clinical parameters was proposed to facilitate the prediction of significant liver inflammation in CHB patients. This nomogram had high accuracy in the identification of significant liver inflammation and would be a useful tool for the better management of CHB patients, especially for those with normal ALT.

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