Abstract:Objective To investigate the diagnostic efficiency of γ-glutamyl transpeptidase to platelet ratio (GPR) for detecting liver fibrosis in chronic hepatitis B patients, and to compare its efficiency with those of liver stiffness measurement (LSM) value, asperate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4). Methods We retrospectively included patients with chronic hepatitis B who had undergone surgery or liver biopsy in our hospital from May 2015 to Sep. 2015. All patients had undergone transient elastography to record LSM value and serological examination to calculate GPR, APRI and FIB-4 before surgery or liver biopsy. The diagnostic efficiency of each index was evaluated by receiver operating characteristic (ROC) curve and the area under ROC curve was compared. Results Totally 260 patients were eventually enrolled in the present study, including 213 males and 47 females, with the average age being (53.49±9.78) years and the average BMI being (23.36±3.06) kg/m2. GPR, LSM value, APRI and FIB-4 were moderately correlated with S ≥ 2 and S4 liver fibrosis (all P<0.05). The areas under ROC curves of GPR, LSM value, APRI and FIB-4 for S ≥ 2 liver fibrosis were 0.81, 0.82, 0.75 and 0.72, respectively. For predicting S4 liver fibrosis, the areas under ROC curves of GPR, LSM value, APRI and FIB-4 were 0.82, 0.86, 0.79 and 0.75, respectively. The areas under ROC curves of GPR and LSM value were significantly higher than those of FIB-4 for detecting S ≥ 2 and S4 liver fibrosis (all P<0.05). For predicting S4, the area under ROC curve of LSM value was significantly better than APRI (P<0.05). There were no statistical differences in the areas under ROC curves between APRI and FIB-4 for diagnosis of S ≥ 2 and S4 liver fibrosis (P>0.05). Conclusion It has been indicated that GPR, LSM value, APRI and FIB-4 have diagnostic accuracy for S ≥ 2 and S4 liver fibrosis. The diagnostic accuracy of LSM value and GPR for S ≥ 2 and S4 liver fibrosis is better than that of FIB-4, and that of LSM value for S4 liver fibrosis is better than that of APRI. Therefore, GPR and LSM value may serve as the optimal indexes for noninvasively evaluating liver fibrosis in chronic hepatitis B patients.