ArticlePediatric surgery international2023
Development and validation of non-invasive models in predicting advanced fibrosis of choledochal cyst.
Article in Pediatric surgery international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.
- KASL clinical practice guidelines for noninvasive tests to assess liver fibrosis in chronic liver disease.Clinical and molecular hepatology · 2024Guideline
- Pathological analysis of liver and cyst wall in prenatally diagnosed choledochal cysts in children.European journal of pediatrics · 2026Article
- Predictive value of cyst size for clinical symptoms in patients with prenatally diagnosed choledochal cysts.Translational pediatrics · 2026Article
- Association of alkaline phosphatase to albumin ratio with all-cause mortality in critically ill patients with cirrhosis: a retrospective study.BMC gastroenterology · 2025Article
- Risk factors analysis for significant liver fibrosis of prenatally diagnosed choledochal cysts: a retrospective case-control study.Frontiers in pediatrics · 2025Article
- Diagnosis of Multiple Organ Dysfunction in Neonates with Hypoxic-Ischemic Encephalopathy: Vasoactive Inotropic Score, Renal Score, Fibrosis-5 Index and Lactate/Albumin Ratio.Diagnostics (Basel, Switzerland) · 2024Article
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Authors and funding
5 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposePatients with choledochal cyst (CDC) develop liver fibrosis, especially advanced fibrosis without prompt surgery. This study validated the aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and Fibrosis-4 index (FIB-4) and constructed a model for predicting advanced fibrosis in pediatric CDCs.
methodsBetween January 2020 and March 2022, 330 CDCs (advanced fibrosis: 34, Ludwig staging 3-4; non-advanced fibrosis: 296, Ludwig staging 0-2) were reviewed. APRI and FIB-4 were validated. The area under the receiver operating characteristic (AUROC) curve was used to assess discrimination. Relevant variables were analyzed by backward stepwise logistic regression. Enhanced bootstrap method was used for internal verification with 1000 samples.
resultsThe AUROCs of APRI and FIB-4 were 0.761 (0.673-0.850) and 0.561 (0.455-0.667). AST to prealbumin ratio (APAR), was constructed with an AUROC of 0.776 (0.693-0.860). The AUROCs of APAR + APRI and APAR + FIB-4 were 0.791 (0.713-0.869) and 0.782 (0.699-0.865). No significant differences were noted in the AUROCs of the indices or their combinations. APAR and APRI could be used together to reduce missed diagnosis rate. The risk of advanced fibrosis varied from different APAR and APRI scores.
conclusionBoth APAR and APRI were indispensable to identify CDC patients at high risk of advanced fibrosis.
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