• Li-Yuan Yang, Jie Fu, Xiao-Fang Peng, Shu-Yin Pang, Kan-Kan Gao, Zheng-Rong Chen, Li-Juan He, Zhe Wen, Hui Wang, Le Li, Feng-Hua Wang, Jia-Kang Yu, Yi Xu, Si-Tang Gong, Hui-Min Xia, and Hai-Ying Liu.
• Li-Yuan Yang, Xiao-Fang Peng, Shu-Yin Pang, Kan-Kan Gao, Hai-Ying Liu, Clinical Laboratory, Guangzhou Medical University Affiliated Guangzhou Women and Children's Medical Center, Guangzhou 510120, Guangdong Province, China.
• World J. Gastroenterol. 2015 May 21; 21 (19): 5893-900.

AimTo validate the value of aspartate aminotransferase to platelet ratio index (APRI) in assessment of liver fibrosis and prediction of postoperative prognosis of biliary atresia (BA) infants from Mainland China.MethodsMedical records of 153 BA infants who were hospitalized from January 2010 to June 2013 were reviewed. The efficacy of APRI for diagnosis of liver fibrosis was assessed using the receiver operator characteristic (ROC) curve compared to the pathological Metavir fibrosis score of the liver wedge specimens of 91 BA infants. The prognostic value of preoperative APRI for jaundice persistence, liver injury, and occurrence of cholangitis within 6 mo after KP was studied based on the follow-up data of 48 BA infants.ResultsAPRI was significantly correlated with Metavir scores (rs = 0.433; P < 0.05). The mean APRI value was 0.76 in no/mild fibrosis group (Metavir score F0-F1), 1.29 in significant fibrosis group (F2-F3), and 2.51 in cirrhosis group (F4) (P < 0.001). The area under the ROC curve (AUC) of APRI for diagnosing significant fibrosis and cirrhosis was 0.75 (P < 0.001) and 0.81 (P = 0.001), respectively. The APRI cut-off of 0.95 was 60.6% sensitive and 76.0% specific for significant fibrosis diagnosis, and a threshold of 1.66 was 70.6% sensitive and 82.7% specific for cirrhosis. The preoperative APRI in infants who maintained jaundice around 6 mo after KP was higher than that in those who did not (1.86 ± 2.13 vs 0.87 ± 0.48, P < 0.05). The AUC of APRI for prediction of postoperative jaundice occurrence was 0.67. A cut-off value of 0.60 showed a sensitivity of 66.7% and a specificity of 83.3% for the prediction of jaundice persistence. Preoperative APRI had no significant association with later liver injury or occurrence of cholangitis.ConclusionOur study demonstrated that APRI could diagnose significant liver fibrosis, especially cirrhosis in BA infants, and the elevated preoperative APRI predicts jaundice persistence after KP.

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