Deep learning-based multimodal model for predicting on-treatment histological outcomes in chronic hepatitis B-associated advanced liver fibrosis

doi:10.3748/wjg.v32.i15.116679

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World Journal of Gastroenterology

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World J Gastroenterol. Apr 21, 2026; 32(15): 116679
Published online Apr 21, 2026. doi: 10.3748/wjg.v32.i15.116679

Table 1 Baseline characteristics of reversal and non-reversal patients, n (%)/mean ± SD/median (Q1-Q3)

Characteristics	Training and validation sets				Test set
Characteristics	Overall (n = 164)	Reversal (n = 63)	Non-reversal (n = 101)	P value	Overall (n = 74)	Reversal (n = 40)	Non-reversal (n = 34)	P value
Demography
Age (years)	42.85 ± 10.06	43.53 ± 11.50	42.44 ± 9.10	0.52	41.96 ± 10.21	37 (34.50-42)	47 (39-50.75)	0.001
Gender				0.49				0.09
Male	104 (63.80)	37 (59.68)	67 (66.34)		55 (75.34)	33 (84.62)	22 (64.71)
Female	59 (36.20)	25 (40.32)	34 (33.66)		18 (24.66)	6 (15.38)	12 (35.29)
Drinks	30 (18.40)	10 (16.13)	20 (19.80)	0.70	5 (6.85)	2 (5.13)	3 (8.82)	0.66
Smoke	33 (20.25)	10 (16.13)	23 (22.77)	0.41	7 (9.59)	4 (10.26)	3 (8.82)	1
BMI (kg/m²)	23.53 (21.15-25.41)	23.47 (21.72-25.38)	23.63 (20.96-25.43)	0.85	23.03 (21.51-24.82)	23.18 (21.14-24.56)	23.03 (21.72-25)	0.54
Laboratory tests
PLT (10⁹/L)	165.50 (120-198.50)	177.50 (132-209.50)	164 (115-187)	0.02	153.73 ± 50.19	160.13 ± 49.54	144.68 ± 50.11	0.19
ALB (g/L)	42 (39.45-45)	42 (39.78-44)	42 (39-45)	0.62	42.40 ± 4.60	42.50 ± 3.65	42.28 ± 5.55	0.84
PT (seconds)	12.70 (11.70-13.70)	12.75 (11.70-13.57)	12.6 (11.90-14)	0.45	12.30 ± 1.60	12.60 ± 1.54	12.01 ± 1.63	0.11
ALT (IU/L)	51 (32.50-103)	54 (27.25-107.25)	50 (36-100)	0.70	47 (30-90)	55 (32-92)	42 (29.25-66.60)	0.48
AST (IU/L)	44 (29-73)	41 (28.20-73.50)	45 (30-69)	0.50	34 (27-69)	33 (27.50-74.50)	34.50 (26-65.75)	0.69
ALP (U/L)	81.50 (67-104)	76 (65.75-90.25)	89 (68-114.50)	0.01	76 (60.75-90.25)	72 (60-89.50)	80.50 (67-90.25)	0.67
GGT (U/L)	38 (22-70.75)	32 (21-54)	45 (22-75.50)	0.08	32.5 (20-67)	30 (20-48)	34.5 (20-71.50)	0.48
TBiL (μmol/L)	13 (10.15-17)	12 (9.85-16.58)	13.7 (11-17)	0.22	15.40 (12.23-21.10)	15.70 (13.40-20.70)	16 (12.16-23.28)	0.68
AFP (ng/mL)	5 (2.34-9)	4.88 (2.30-9.20)	5 (2.34-8.88)	0.75	5.2 (2.90-11.80)	4.51 (2.59-15.92)	5.38 (3.14-9.51)	0.47
Fibrosis staging models
LSM (kPa)	10.6 (6.35-16.30)	8.85 (5.80-12.80)	12.30 (7.60-18.50)	0.002	8.3 (6.20-15.30)	7.6 (6.15-14)	9.8 (6.40-16.15)	0.270
APRI	0.73 (0.41-1.39)	0.58 (0.39-1.18)	0.76 (0.46-1.51)	0.08	0.74 (0.40-1.20)	0.77 (0.37-1.19)	0.7 (0.47-1.29)	0.70
FIB4	1.63 (1.10-2.67)	1.53 (0.97-2.39)	1.69 (1.15-2.83)	0.27	1.57 (1.08-2.54)	1.43 (1.03-2.02)	1.8 (1.17-3)	0.07
HBV markers
HBsAg¹	3.46 (3.09-4.01)	3.59 (3.18-4.11)	3.45 (2.98-3.85)	0.21	3.5 (3.06-4.04)	3.56 ± 0.91	3.53 ± 0.70	0.86
HbeAg				1.00				0.20
Positive	101 (61.96)	38 (61.29)	63 (62.38)		37 (50.68)	23 (58.97)	14 (41.18)
Negative	62 (38.04)	24 (38.71)	38 (37.62)		36 (49.32)	16 (41.03)	20 (58.82)
HBV DNA¹	5.98 (4.75-7.33)	6.67 (4.89-7.78)	5.71 (4.75-7.17)	0.13	6.28 (5.04-7.75)	6.91 (5.23-8.01)	5.52 (4.95-6.63)	0.07
Histology
HAI				0.04				0.34
1-4	32 (19.63)	8 (12.90)	24 (23.76)		18 (24.66)	8 (20.51)	10 (29.41)
5-8	92 (56.44)	42 (67.74)	50 (49.50)		38 (52.05)	20 (51.28)	18 (52.94)
9-12	38 (23.31)	11 (17.74)	27 (26.73)		16 (21.92)	11 (28.21)	5 (14.71)
13-18	1 (0.61)	1 (1.61)	0 (0)		1 (1.37)	0 (0)	1 (2.94)
Ishak score				0.73				0.27
3	47 (28.83)	21 (33.87)	26 (25.74)		24 (32.88)	15 (38.46)	9 (26.47)
4	24 (14.72)	8 (12.90)	16 (15.84)		12 (16.44)	8 (20.51)	4 (11.76)
5	31 (19.02)	11 (17.74)	20 (19.80)		17 (23.29)	6 (15.38)	11 (32.35)
6	61 (37.42)	22 (35.48)	39 (38.61)		20 (27.40)	10 (25.64)	10 (29.41)

¹Represents log10 IU/mL.

BMI: Body mass index; PLT: Platelet; ALB: Albumin; PT: Prothrombin time; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: γ-glutamyltransferase; TBiL: Total bilirubin; AFP: Alpha-fetoprotein; LSM: Liver stiffness measurement; APRI: Aspartate aminotransferase to platelet index; FIB4: Fibrosis index based on 4 factors; HBV: Hepatitis B virus; HBsAg: Hepatitis B surface antigen; HBeAg: Hepatitis B e antigen; HAI: Histologic activity index.

Full Size Table

Table 2 Univariate and multivariate analysis of the clinical variables associated with fibrosis reversal

Characteristics	Univariate analysis		Multivariate analysis
Characteristics	OR (95%CI)	P value	OR (95%CI)	P value
PT (seconds)	1.333 (1.005-1.766)	0.046	1.200 (0.896-1.609)	0.222
ALP (U/L)	1.016 (1.000-1.031)	0.044	1.006 (0.990-1.023)	0.462
LSM (kPa)	1.092 (1.025-1.163)	0.007	1.073 (1.003-1.149)	0.041
Age (years)	1.111 (0.500-2.470)	0.796
Sex	1.008 (0.464-2.190)	0.983
Drinking	0.975 (0.371-2.562)	0.959
Smoking	0.700 (0.262-1.872)	0.477
BMI (kg/m²)	1.027 (0.931-1.133)	0.591
PLT (10⁹/L)	0.996 (0.989-1.002)	0.169
ALB (g/L)	1.011 (0.924-1.106)	0.809
ALT (IU/L)	1.000 (0.996-1.005)	0.931
AST (IU/L)	0.999 (0.992-1.006)	0.793
GGT (U/L)	0.999 (0.997-1.001)	0.432
TBil (μmol/L)	1.053 (0.983-1.129)	0.142
AFP (ng/mL)	1.006 (0.993-1.018)	0.376
APRI	1.001 (0.716-1.397)	0.997
FIB4	1.058 (0.830-1.350)	0.648
HBsAg¹	0.783 (0.449-1.366)	0.389
HBV DNA¹	0.833 (0.651-1.066)	0.146

¹Represents log10 IU/mL.

OR: Odds ratio; CI: Confidence interval; PT: Prothrombin time; ALP: Alkaline phosphatase; LSM: Liver stiffness measurement; BMI: Body mass index; PLT: Platelet count; ALB: Albumin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGT: γ-glutamyltransferase; TBiL: Total bilirubin; AFP: Alpha-fetoprotein; APRI: Aspartate aminotransferase to platelet index; FIB4: Fibrosis index based on 4 factors; HBsAg: Hepatitis B surface antigen; HBV: Hepatitis B virus.

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Table 3 Predictive performances for different model in the validation set

Metrics	Clinical	HE	Masson	HE + Masson	Multimodal model
AUC (mean)	0.658	0.657	0.727	0.732	0.741
AUC (95%CI)	0.502-0.812	0.494-0.800	0.575-0.857	0.580-0.862	0.588-0.869
Sensitivity	0.586	0.828	0.724	0.724	0.655
Specificity	0.667	0.381	0.381	0.619	0.667
PPV	0.708	0.649	0.618	0.724	0.731
NPV	0.538	0.615	0.500	0.619	0.583

HE: Hematoxylin and eosin; AUC: Area under the receiver operating characteristic curve; CI: Confidence interval; PPV: Positive predictive value; NPV: Negative predictive value.

Full Size Table

Table 4 Predictive performances for different model in the test set

Metrics	Clinical	HE	Masson	HE + Masson	Multimodal model
AUC (mean)	0.588	0.615	0.676	0.690	0.694
AUC (95%CI)	0.456-0.716	0.484-0.741	0.547-0.799	0.564-0.812	0.570-0.815
Sensitivity	0.412	0.882	0.706	0.647	0.647
Specificity	0.750	0.250	0.450	0.525	0.525
PPV	0.583	0.500	0.522	0.537	0.537
NPV	0.600	0.714	0.643	0.636	0.636

HE: Hematoxylin and eosin; AUC: Area under the receiver operating characteristic curve; CI: Confidence interval; PPV: Positive predictive value; NPV: Negative predictive value.

Full Size Table

Citation: Han W, Cheng DY, He QW, Wang SH, Gong SJ, Chen Y, Yang YP. Deep learning-based multimodal model for predicting on-treatment histological outcomes in chronic hepatitis B-associated advanced liver fibrosis. World J Gastroenterol 2026; 32(15): 116679
URL: https://www.wjgnet.com/1007-9327/full/v32/i15/116679.htm
DOI: https://dx.doi.org/10.3748/wjg.v32.i15.116679