Evaluation of Aspartate Aminotransferase-to-Platelet Ratio Index as a Non-Invasive Marker for Liver Cirrhosis
Published: November 1, 2015 | DOI: https://doi.org/10.7860/JCDR/2015/.6814
Princi Jain, B.K.Tripathi, B.Gupta, Bharti Bhandari, Divesh Jalan
1. Ex Resident, Department of Medicine, VMMC & SJH, New Delhi, India.
2. Professor, Department of Medicine, VMMC & SJH, New Delhi, India.
3. Ex Professor and Head, Department of Medicine, VMMC & SJH, New Delhi, India.
4. Assistant Professor, Department of Physiology, AIIMS, Jodhpur, India.
5. Assistant Professor, Department of Orthopaedics, AIIMS, Jodhpur, India.
Correspondence Address :
Dr. Princi Jain,
Ex Resident, Department of Medicine, VMMC & SJH, New Delhi-110029, India.
E-mail: princija@gmail.com
Abstract
Introduction: Liver biopsy is considered as a gold standard for the diagnosis of cirrhosis. Till date there is no non-invasive marker to replace it.
Aim: To investigate the effectiveness of Aspartate aminotransferase-to-platelet ratio index (APRI) as a non-invasive marker for liver cirrhosis. Materials and Methods: Fifty-one patients with cirrhosis, identified on USG abdomen were included in study. Platelet count and Aspartate aminotransferase (AST) were done using haematology automatic analyser and automatic HITACHI-912 Auto Analyser respectively. APRI was calculated for every patient using the formula {(AST / ULN) x 100}/platelet count (109/L). Predictive accuracy was evaluated with a receiver-operating characteristics (ROC) curve.
Results: APRI correctly classified 49 (96.1%) patients of cirrhosis with area under the ROC curve of 0.973 (95% CI) at cut-off 0.65 with negative predictive value (NPV) and Positive predictive value (PPV) of 96% and 96.1% respectively. The sensitivity and specificity of the test was found to be 96% and 96.1% respectively.
Conclusion: APRI could identify cirrhosis with high degree of accuracy in the studied patients.
Keywords
Cirrhosis, Liver enzymes, Platelet count