Evaluation of hepatic fibrosis using Aspartate aminotransferase-to-Platelet Ratio Index in children with biliary atresia

Objective To investigate the correlation between the degree of liver fibrosis and Aspartate aminotransferase-to-Platelet Ratio Index (APRI) in children with biliary atresia(BA), and evaluate the clinical significance of liver fibrosis in biliary atresia. Methods A total of 97 patients with diagnosed BA were recruited between January 2010 and June 2013.AST, PLT and APRI were determined one week before laparotomy. The severity of hepatic tibrosis was. Judged by Metavir system the correlation among AST, PLT, APRI and severity of liver fibrosis were evaluated, and their diagnostic value for degree of liver fibrosis was analyzed by ROC. Results Sera AST levels and PLT counts of BA patients were found to be positively(r=0.367, P<0.01) and negatively(r=-0.403, P<0.01) correlated with Metavir scores of liver fibrosis, respectively. There existed positive correlation between APRI and the severity of hepatic fibrosis (r=0.541, P<0.01). The area under ROC curve of APRI to diagnose none or mild fibrosis and moderately severe fibrosis was 0.78, with sensitivity of 77.9% and specificity of 62.1% at the optimal cut-off value of 0.75; the area under ROC curve of APRI to diagnose moderately severe fibrosis with liver cirrhosis arrived 0.85, with sensitivity of 75.0% and specificity of 89.4% at the optimal cut-off value of 1.77. The accuracy of none or mild fibrosis, moderate fibrosis and cirrhosis diagnosed by APRI were 73.2%, 64.9%, 87.6%, respectively. Conclusion APRI can be used as a non-invasive parameter to assess the severity of hepatic fibrosis with BA.(Chin J Lab Med, 2015, 38: 337-340) Key words: Biliary atresia; Liver cirrhosis; Severity of illness index; Aspartate aminotransferases; Platelet count; Odds ratio