ROC curve analysis of blood platelet and hyaluronic acid levels for diagnosing cirrhosis
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摘要: 目的应用受试者工作特征(ROC)曲线分析血小板(PLT)计数与透明质酸(HA)对肝硬化的诊断价值。方法收集377例慢性HBV感染者,分为慢性乙型肝炎组233例,乙型肝炎肝硬化组144例。化学发光法检测HA,全自动血细胞分析仪检测外周血的PLT计数,进行ROC曲线分析。结果 (1)PLT计数诊断肝硬化的ROC曲线下面积(AUC)为0.888±0.0165,截断值为91×109/L,以PLT计数≤91×109/L来预测肝硬化灵敏度为84.03%,特异度为82.83%。HA的AUC为0.920±0.0138,截断值为308nmol.ml-1.h-1),以HA>308 nmol.ml-1.h-1来预测肝硬化灵敏度为84.72%,特异度为88.84%。PLT与HA的AUC之间的差异无统计学意义(P=0.089),二指标均为诊断肝硬化的优良指标。(2)以公式log10(PLT/HA)判断两个指标联合对肝硬化的诊断价值,所得AUC为0.945±0.0113,截断值为-0.595,以log10(PLT/HA)≤-0.595来预测肝硬化灵敏度为88.19%,特异度为89.7%。AUC两两比较显示l...Abstract: Objective To investigate the diagnostic value of blood platelet (PLT) and hyaluronic acid (HA) levels for cirrhosis.Methods Coded peripheral blood samples obtained from chronic hepatitis B virus (HBV) infection patients (n=233) and HBV-related liver cirrhosis patients (n=144) were used to measure blood PLT counts by an automated blood cell analyzer and serum HA levels by chemiluminescent assay.Correlation of PLT counts and HA levels with HBV-related cirrhosis was analyzed by receiver operating characteristic (ROC) curve analysis.Results For PLT, the area under the curve (AUC) was 0.888±0.0165.The PLT cutoff value was determined to be≤91×109/L, which provided diagnostic sensitivity of 84.03% and specificity of 82.83%.Meanwhile, the HA AUC was 0.920±0.0138.The HA cutoff value was determined to be>308 nmol·ml-1·h-1, which provided diagnostic sensitivity of 84.72% and specificity of 88.84%.The AUCs of PLT and HA were not significantly different (P=0.089) , suggesting that both PLT and HA are excellent indexes of cirrhosis.Furthermore, the AUC of log10 (PLT/HA) was 0.945±0.0113 and the cutoff value was determined to be ≤-0.595, which provided diagnostic sensitivity of 88.19% and specificity of 89.7%.The AUC of log10 (PLT/HA) and PLT (P=0.0008) was significantly different from the AUC of log10 (PLT/HA) and HA (P<0.0001) , suggesting that combined detection of PLT and HA will be more valuable for diagnosis of cirrhosis.Conclusion Combined detection of PLT and HA represents a reliable method to diagnose cirrhosis in patients with hepatitis B, and may be especially useful in cases lacking histopathologic findings.
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Key words:
- ROC curve /
- platelet count /
- hyaluronic acid /
- liver cirrhosis
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