• Beom Kyung Kim, Sung Ae Kim, Young Nyun Park, Jae Youn Cheong, Hwa Sook Kim, Jun Yong Park, Sung Won Cho, Kwang-Hyub Han, Chae Yoon Chon, Young Myoung Moon, and Sang Hoon Ahn.
• Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
• Liver Int. 2007 Sep 1; 27 (7): 969-76.

ObjectivesFew noninvasive models of chronic hepatitis B (CHB) to predict liver cirrhosis have been studied. The aim of the current study is to investigate the diagnostic accuracy of two simple novel models of spleen-platelet ratio index (SPRI) and age-spleen-platelet ratio index (ASPRI) in patients with CHB.Patients And MethodsA total of 346 consecutive treatment-naïve patients with CHB were retrospectively studied. The aspartate to alanine aminotransferase ratio (AAR), age-platelet index (API), aspartate aminotransferase to platelet ratio index (APRI), SPRI, and ASPRI were compared with liver histology.ResultsAAR, APRI, SPRI, API, and ASPRI correlated significantly to fibrosis stage (all P<0.001). The diagnostic accuracy of ASPRI was the highest among five tests for prediction of cirrhosis (area under receiver operating characteristic curve, AUROC=0.893). Using a cutoff score of ASPRI>12, the presence of cirrhosis could be correctly identified with a high accuracy (96.3% positive predictive value) in 35 (10.1%) of 346 patients. Similarly, using a cutoff of <5, the presence of cirrhosis could be totally excluded with 100% of negative predictive value in 120 (34.7%) of 346 patients.ConclusionASPRI was accurate in predicting cirrhosis and screening with ASPRI has the potential to reduce the number of liver biopsies in CHB patients.

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