ROC curve analysis of blood platelet and hyaluronic acid levels for diagnosing cirrhosis

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.