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Assessment of liver fibrosis with the gamma-glutamyl transpeptidase to platelet ratio: a multicentre validation in patients with HBV infection
  1. Xiao-Jie Lu1,2,
  2. Xiu-Hui Li3,
  3. Zhao-Xin Yuan4,5,
  4. Hai-Ying Sun5,
  5. Xiao-Chen Wang1,2,
  6. Xiaolong Qi6,
  7. Xin Zhang7,
  8. Beicheng Sun1,2
  1. 1Department of Liver Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
  2. 2Department of Hepatobiliary Surgery, The Affiliated Drum Tower Hospital of NanjingUniversity Medical School, Nanjing, China
  3. 3Department of Integrated Traditional Chinese Medicine and Western Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China
  4. 4Changchun Medical College, Changchun, Jilin, China
  5. 5Department of Hepatology, Hepatobiliary Disease Hospital of Jilin Province, Changchun, Jilin, China
  6. 6Guangdong Provincial Research Center for Liver Fibrosis, Institute of Hepatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
  7. 7Department of Medical Imaging, The Fourth Hospital of Huai’an, Huai’an, China
  1. Correspondence to Dr Beicheng Sun, Department of Liver Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China; sunbc{at}njmu.edu.cn and Dr Xin Zhang, Department of Medical Imaging, The Fourth Hospital of Huai’an, Huai’an, China; 973306782{at}qq.com

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We read with interest the study by Lemoine et al1 in which the gamma-glutamyl transpeptidase (GGT) to platelet ratio (GPR) was developed to stage fibrosis in patients with chronic hepatitis B (CHB). This study concluded that GPR is more accurate than the aspartate aminotransferase to platelet ratio index (APRI) and Fib-4 to stage liver fibrosis in patients with CHB. As China is a highly endemic area of CHB with estimated >74 million hepatitis B surface antigen (HBsAg)-positive patients,2 3 we conducted this multicentre study to validate the diagnostic performance of GPR in Chinese patients with CHB.

Treatment-naïve patients with positive HBsAg who underwent liver biopsy, Fibroscan (FS402, Echosens, France) and blood tests were included from three centres (Huai’an Fourth People’s Hospital, Huai’an, China (January 2012–April 2016), Beijing You-An Hospital, Capital Medical University, Beijing, China (January 2014–June 2016) and Hepatology Hospital of Jilin …

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