Comparison of serological fibrosis markers with liver biopsy fibrosis stages in chronic hepatitis B patients

Purpose: Hepatitis B virus is the most common cause of chronic hepatitis and is a serious health issue today. Determining the degree of liver fibrosis is the main step of treatment. Biochemical, serological and molecular tests, histopathological examination, imaging are the methods used for diagnosis and staging. This thesis study aimed to detect the serological markers closest to the liver biopsy results and to determine the cut-off value by comparing the liver biopsy results and biochemical fibrosis markers of patients followed up with chronic hepatitis B infection. Materials and Methods: Patients between the ages of 18 and 90, who were admitted to Samsun Training and Research Hospital as outpatients and were followed for Chronic Hepatitis B infection and whose HBV-DNA level was > 2000 IU/ml at least once and who underwent liver biopsy with fibrosis staging, were included in the study. The demographic characteristics, pathology results and biochemical data of the patients were recorded retrospectively as file findings. The evaluated variables and serological fibrosis markers (FIB4, APRI, GPR, AGAP, AAR, NLR, RPR, King's score, FibroQ, API, PLR, AAPRI, APPR, GUCI, Lok score, GAR, FI) were statistically assessed for their diagnostic validity in predicting liver fibrosis by comparing them with the Ishak fibrosis stage, and the cut-off value was determined. Results: In our study, as a result of the ROC analysis performed to determine the threshold values of factors that can predict advanced fibrosis (F4-6), FIB4, APRI, GPR, AGAP, AAR, RPR, King's score, API, PLR, APPR, GUCI, Lok score, GAR, FI serum tokens were successful. The highest AUROC value was APRI (0.791, p<0.001) and followed by GUCI, APPR, Kings, AGAP, GPR, FIB4, FI (0.784, 0.780, 0.771, 0.748, 0.736, 0.734, 0.701, p<0.001, respectively). Conclusion: In cases where diagnosis of liver fibrosis takes a long time, is costly, requires special methods-equipment and qualified evaluation, such as biopsy; noninvasive serum markers that are short-term, low-cost, and easily evaluated can make a significant contribution to predicting fibrosis. However, there is no perfect serum biomarker. It is thought that markers with high predictive power such as APRI, GUCI, APPR, Kings score, AGAP, GPR, FIB4, FI can be beneficial in selected cases.