Predictive value of aspartate aminotransferase-to-platelet ratio index on hepatic fibrosis progression in children with biliary atresia

Objective To investigate the predictive value of aspartate aminotransferase-to-plate let ratio index (APRI) on hepatic fibrosis progression in children with biliary atresia (BA).Methods A total of 93 patients with BA who underwent Kasai procedure were recruited in this study.The clinical data including laboratory tests and pathological examines were collected and analyzed retrospectively.Wedge hepatic biopsy was performed during surgical procedure.Live cirrhosis was determined by pathological examination.The severity of cirrhosis was graded using Scheuer classification.Results The total cases were divided into 2 subgroups:none or mild (stage 0-1) group,and severe fibrosis group (stage 2-4).The AST,ALT,PLT,AST/ALT and APRI were compared,and significant difference was found between 2 groups (all P＜0.05).The area under ROC curve of AST,ALT,PLT,AST/ALT and APRI were 0.777,0.631,0.351,0.605 and 0.783,respectively.The optimal cut-off of APRI was 0.945.The sensitivity and specificity of APRI for prediction liver fibrosis were 0.817 and 0.67,respectively.APRI was found to be moderate correlated with the severity of hepatic fibrosis (r =0.483,P＜0.01),which was increased with the severity of hepatic fibrosis.The 2-year survival rate of the patients with APRI＞0.945 was significantly higher than that with APRI≤0.945.Conclusions APRI is positively correlated with the severity of hepatic fibrosis in patients with BA,which can be used to predict hepatic cirrhosis progression. Key words: Biliary atresia; Liver cirrhosis; Aspartate aminotransferases; Blood platelets