Is the P2/Ms score a reliable method for detecting fibrosis stage in patients with steatohepatitis?

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Karahanlı C., Topal F., Kurt I., Taşdemir Ü., Gündüz I.

Kastamonu Medical Journal, cilt.5, ss.259-264, 2025 (TRDizin)

Özet

Aims: This study aimed to evaluate the utility of the P2/MS score in detecting liver fibrosis severity in patients with non-alcoholic

steatohepatitis (NASH), alongside established noninvasive markers such as FIB-4 and APRI. Additionally, we sought to examine

changes in these markers across patients with non-alcoholic fatty liver disease (NAFLD), NASH, and healthy controls, and their

relationship with the NAFLD activity score (NAS).

Methods: A total of 264 patients were retrospectively analyzed: 99 healthy controls, 100 NAFLD patients, and 65 NASH patients

diagnosed by liver biopsy. Laboratory parameters and noninvasive fibrosis scores (FIB-4, APRI, P2/MS) were compared among

groups. In the NASH subgroup, we evaluated the ability of these indices to distinguish fibrosis stages and NAS ≥5. Statistical

analysis was performed using IBM SPSS v25.0.

Results: The FIB-4 Index effectively distinguished fibrosis stages, particularly METAVIR 3&4 versus lower stages (p<0.001),

and APRI also showed significant discriminatory capacity (p=0.005). In contrast, the P2/MS score did not show any significant

association with fibrosis stages (p=0.137) or with group classification (control, NAFLD, NASH). Similarly, while FIB-4 and APRI

increased progressively from control to NAFLD to NASH (p<0.001), P2/MS values remained statistically unchanged across

groups. None of the noninvasive scores-including P2/MS-were effective in predicting NAS ≥5.

Conclusion: The P2/MS score failed to demonstrate clinical utility in differentiating fibrosis severity or distinguishing between

NAFLD, NASH, and healthy individuals. In contrast, FIB-4 and APRI were significantly more reliable in identifying advanced

fibrosis in NASH patients. These findings do not support the use of the P2/MS score in routine clinical assessment of NASHrelated

fibrosis.