Surana P, Hercun J, Takyar V, Kleiner DE, Heller T, Koh C. Platelet count as a screening tool for compensated cirrhosis in chronic viral hepatitis. World J Gastrointest Pathophysiol 2021; 12(3): 40-50 [PMID: 34084591 DOI: 10.4291/wjgp.v12.i3.40]
Corresponding Author of This Article
Christopher Koh, FAASLD, MD, MHSc, Associate Professor, Clinical Director, Doctor, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 10 Center Drive, Room 5-2740, Bethesda, MD 20892, United States. christopher.koh@nih.gov
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pathophysiol. May 22, 2021; 12(3): 40-50 Published online May 22, 2021. doi: 10.4291/wjgp.v12.i3.40
Table 1 Baseline demographics
Training (n = 715)
Validation (n = 312)
P value
Age (yr)
45.6 (10.7)
44.5 (11.1)
0.1
Male/female (%)
66/34
66/34
1.0
Platelets (× 109/L)
186.7 (64.4)
190.6 (68.2)
0.4
Alanine aminotransferase (IU/L)
103.8 (88.1)
105.1 (89.1)
0.8
Aspartate aminotransferase (IU/L)
69.9 (55.0)
68.0 (53.3)
0.6
Albumin (g/dL)
3.9 (0.46)
3.9 (0.39)
0.2
Alkaline phosphatase (IU/L)
82.3 (39.2)
79.0 (29.2)
0.1
Prothrombin time (s)
13.0 (1.3)
12.9 (1.1)
0.3
Total bilirubin (mg/dL)
0.81 (0.48)
0.77 (0.45)
0.2
Ishak fibrosis
2.4 (1.8)
2.3 (1.7)
0.3
HAI inflammation
8.0 (3.0)
7.9 (3.1)
0.5
HBV/HCV/HDV (%)
23/68/8
23/68/9
1.0
Table 2 Spearman correlations between Ishak fibrosis and liver tests within training cohort
R
P value
Platelets
-0.49
< 0.0001
AST
0.51
< 0.0001
ALT
0.37
< 0.0001
Alkaline phosphatase
0.35
< 0.0001
Prothrombin time
0.33
< 0.0001
Albumin
-0.30
< 0.0001
Total bilirubin
0.18
< 0.0001
Table 3 Area under the curve using selected liver tests within the training cohort
Platelets
ALT
AST
Alkaline phosphatase
Prothrombin time
0.86 (0.82, 0.90)
0.65 (0.59, 0.71)
0.76 (0.71, 0.81)
0.76 (0.71, 0.81)
0.77 (0.71, 0.82)
Table 4 Performance of optimal platelet cut-offs in validation cohort
Platelet cut-off (× 109/L)
AUROC
Sensitivity (%)
Specificity (%)
Positive predictive value (%)
Negative predictive value (%)
Entire validation cohort
143
0.85 (0.76-0.93)
79
84
33
98
HBV
143
0.81 (0.53-1.00)
83
82
29
98
HCV
143
0.83 (0.72-0.94)
75
86
31
98
HDV
143
0.87 (0.74-1.00)
100
60
47
100
Table 5 Performance of platelet cut-offs in training cohort
Platelet counts (× 109/L)
Sensitivity (%)
Specificity (%)
Positive predictive value (%)
Negative predictive value (%)
130
67
91
57
94
140
73
86
48
95
143
74
83
44
94
150
78
78
38
95
Citation: Surana P, Hercun J, Takyar V, Kleiner DE, Heller T, Koh C. Platelet count as a screening tool for compensated cirrhosis in chronic viral hepatitis. World J Gastrointest Pathophysiol 2021; 12(3): 40-50