The relationship between serum fibrosis markers and fibrosis in liver tissue in patients with chronic viral hepatitis

Abstract number: 1733_722

Candevir A., Aksu H.S.Z., Kurtaran B., Inal A.S.

Introduction: In management of chronic hepatitis, measuring the degree of hepatic fibrosis and inflammation is crucial. Today the golden standard is showing the fibrosis and inflammation at the liver tissue via liver biopsy and pathological scoring systems. In this study, two of the noninvasive markers of fibrosis, hyaluronic acid (HA) and matrix metalloproteinase-2 (MMP-2), which can be used instead of liver biopsy, will be investigated.

Material and Methods: 42 patients of chronic hepatitis (mean age is 38±12, of which 69% male, n = 29) with activation criteria were included to our study. Routine biochemical assays and liver biopsies were performed. The relationship between serum HA, MMP-2 levels and liver fibrosis and histological activity was investigated.

Results: Serum HA levels were found to be increased by increasing liver fibrosis. But it was not statistically significant (p = 0.148). There was no significant relationship between MMP-2 levels and stage (p = 0.583). There was an increase, which is not significant, at serum HA and MMP-2 levels while histological activity was increasing from mild to severe (p = 0.117, p = 0.168 respectively). There was a positive correlation between HA and age (p = 0.002). HA levels were greater at cirrhotic patients than non cirrhotic ones (p = 0.075). The sensitivity and specificity of the HA assay at a cut off value of 50 ng/mL was 66.6% and 80.5% respectively. The likelihood ratio (LR) was 2.95 while positive predictive value (PPV) and negative predictive value (NPV) were 36.4% and 93.6%.

Relationship between serum fibrosis markers (hyaluronic acid [HA] and MMP2) and pathological assessment

  HA (ng/mL)MMP2 (ng/mL)
Median (min–max)61 (15–160)100 (100–4,200)  
Median (min–max)25 (5–375)130 (100–18,000)  
Median (min–max)26 (5–375)100 (100–18,000)  
P-valuea 0.0750.407
Histological activity
Minimal/absent hepatitisN66
Median (min–max)20 (10–45)150 (100–9,000)  
Moderate–severe hepatitisN3029
Median (min–max)26 (5–375)130 (100–18,000)  
Median (min–max)25 (5–375)130 (100–18,000)  
P-valuea 0.4060.871
aMann–Whitney U-test.

Conclusion: As a conclusion, serum HA and MMP-2 levels can not be used instead of liver biopsy and histological assessment which is composed of staging fibrosis and grading inflammation. For routine use of serum fibrosis markers, standard assays and new procedures are needed.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Location: ICC, Munich, Germany
Presentation type:
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