| Title | Development and validation of non-invasive models in predicting advanced fibrosis of choledochal cyst |
| Authors | Chen, Suyun Yin, Tong Li, Long Diao, Mei Huang, Ting |
| Affiliation | Peking Univ, Teaching Hosp, Capital Inst Pediat, Beijing, Peoples R China Peking Union Med Coll, Childrens Hosp Capital Inst Pediat, Grad Sch, Beijing, Peoples R China Capital Inst Pediat, Dept Pediat Surg, Beijing, Peoples R China Tsinghua Univ, Affiliated Beijing Tsinghua Changgung Hosp, Dept Pediat Surg, Beijing, Peoples R China |
| Keywords | CHRONIC HEPATITIS LIVER FIBROSIS ASPARTATE-AMINOTRANSFERASE PLATELET RATIO INDEX THROMBOCYTOPENIA CIRRHOSIS CHILDREN AGE |
| Issue Date | 22-Jan-2023 |
| Publisher | PEDIATRIC SURGERY INTERNATIONAL |
| Abstract | PurposePatients with choledochal cyst (CDC) develop liver fibrosis, especially advanced fibrosis without prompt surgery. This study validated the aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and Fibrosis-4 index (FIB-4) and constructed a model for predicting advanced fibrosis in pediatric CDCs.MethodsBetween January 2020 and March 2022, 330 CDCs (advanced fibrosis: 34, Ludwig staging 3-4; non-advanced fibrosis: 296, Ludwig staging 0-2) were reviewed. APRI and FIB-4 were validated. The area under the receiver operating characteristic (AUROC) curve was used to assess discrimination. Relevant variables were analyzed by backward stepwise logistic regression. Enhanced bootstrap method was used for internal verification with 1000 samples.ResultsThe AUROCs of APRI and FIB-4 were 0.761 (0.673-0.850) and 0.561 (0.455-0.667). AST to prealbumin ratio (APAR), was constructed with an AUROC of 0.776 (0.693-0.860). The AUROCs of APAR + APRI and APAR + FIB-4 were 0.791 (0.713-0.869) and 0.782 (0.699-0.865). No significant differences were noted in the AUROCs of the indices or their combinations. APAR and APRI could be used together to reduce missed diagnosis rate. The risk of advanced fibrosis varied from different APAR and APRI scores.ConclusionBoth APAR and APRI were indispensable to identify CDC patients at high risk of advanced fibrosis. |
| URI | http://hdl.handle.net/20.500.11897/669480 |
| ISSN | 0179-0358 |
| DOI | 10.1007/s00383-023-05373-6 |
| Indexed | SCI(E) |
| Appears in Collections: | 首都儿科研究所 |
