Relationship between Mean Platelet Volume/Platelet Ratio (MPVP), Mean Platelet Volume/Lymphocyte Ratio (MPVL), Neutrophil/Lymphocyte Ratio (NLR), Neutrophil/Albumin Ratio (NPAR) and fibrosis in patients with chronic Hepatitis B

Objective: To investigate the diagnostic value of ratios derived from hematological and biochemical parameters (MPVP, MPVL, NLR, NPAR, PLR) and commonly used non-invasive scores (APRI, FİB-4) in predicting liver fibrosis associated with Chronic Hepatitis B. Methods: This single-center, retrospective, cross-sectional study included 117 patients with HCC (60 male, 57 female) selected from over 600 patients who underwent liver biopsy between 2010 and 2024. Fibrosis was classified between F0 and F4 using the METAVIR score, and binary (F0–F1/F2–F4) and ternary (F0–1/F2/F3–4) categories were also created. The FİB-4 score was created as binary (≤2,67 / >2,67) and ternary (≤1,45 / 1,45–3,25 / ≥3,25) and its relationship with hematological ratios was determined. The Histological Activity Index (HAI) was evaluated on a scale of 0-18. ROC analysis, correlation, and regression tests were used. Results: The mean age of the study group was 49.2±13,7 years, and cirrhosis was detected in 6% of the participants. A significant relationship was found between NPAR and HAI; a moderate correlation was observed between FİB-4 and MPVP (r=0.462) and MPVL (r=0.464), and a weak correlation was found with NLR. A significant relationship was found between NLR, GPR, and NPAR in the advanced fibrosis group. In ROC analyzes, the AUC value for NLR is 0.566, and for NPAR, the value is 0.582. MPVP, MPVL, and PLR were found to have low discriminatory power. FİB-4 has shown higher accuracy in predicting advanced fibrosis. Conclusion: Hemogram and biochemical-based ratios alone cannot reliably predict advanced fibrosis in CHB. However, MPV-based ratios showed a moderate correlation with FİB-4, and it was found that NLR, NPAR, and GPR may be associated with advanced fibrosis. NLR, on the other hand, was found to have poor discriminative ability. A relationship was found between HAI and NPAR; as the HAI score increased, an increase was observed in NPAR. These parameters can be used supportively in clinical practice alongside FİB-4 and imaging methods. Keywords: Chronic hepatitis B; fibrosis; non-invasive markers; NLR; MPV; MPVP; MPVL; NPAR; PLR; FİB-4; APRI.