Combined serum biomarkers in non-invasive diagnosis of non-alcoholic steatohepatitis--Combined biomarkers in NASH non-invasive diagnosis
Background Non-alcoholic steatoheaptitis (NASH) , the critical stage of non-alcoholic fatty liver disease (NAFLD) , is of chronic progression and can develop cirrhosis even hepatocellular carcinoma (HCC).However, non-invasive biomarkers for NASH diagnosis remain poorly applied in clinical practice.Our study aims at testing the accuracy of the combination of cytokeratin-18 M30 fragment (CK-18-M30) ,fibroblast growth factor 21 (FGF-21) ,interleukin 1 receptor antagonist (IL-1Ra) ,pigment epithelium-derived factor (PEDF) and osteoprotegerin (OPG) in diagnosing NAFLD and NASH.Methods 179 patients with biopsy-proven NAFLD were enrolled as training group,91 age-and gender-matched healthy subjects were recruited at the same time as controls.63 otherNAFLD patients were separately collected as validation group.45 alcoholic fatty liver disease (AFLD) patients,50 hepatitis B virus (HBV) patients,52 hepatitis C virus (HCV) patients were also included.Serum biomarker levels were measured by enzyme-linked immunosorbent assay.Results Serum levels of CK-18-M30,FGF-21 ,IL-1Ra and PEDF increased,while OPG decreased in a stepwise fashion in controls,non-NASH NAFLD patients and NASH patients (P < 0.01).The area under receiver-operating characteristics curve to diagnose NASH was 0.86 for CK-18-M30,0.89 for ” ,0.89 for IL-1Ra,0.89 for PEDF and 0.89 for OPG.CK-18-M30 had 70% negative predictive value (NPV) and 79% positive predictive value (PPV) to diagnose NASH.A 5-step approach measuring CK-18-M30 followed by FGF21 ,IL-1Ra,PEDF and OPG gradually improved the NPV to 76% and PPV to 85% ,which reached 80% and 76% respectively in the validation cohort.Conclusion Compared to single biomarker,stepwise combination of CK-18-M30, FGF-21, IL-1 Ra, PEDF and OPG can further improve the accuracy in diagnosing NASH.
Non-alcoholic steatohepatitis Non-invasive diagnosis Combined serum biomarker Accuracy
Yang Mei Xu Dongping Liu Yuan Guo Xiaodong Li Wenshu Guo Chaonan Zhang Hongping Gao Yinjie Mao Yuanli Zhao Jingmin
Department of Pathology and Hepatology,Beijing 302 Hospital,Beijing 100039, China Institute of Infectious Diseases/Liver Failure Medical Center,Beijing 302 Hospital,Beijing 100039,Ch Center for Clinical Trial, Beijing 302 Hospital, Beijing 100039, China Center for Clinical Laboratory, Beijing 302 Hospital,Beijing 100039,China
国内会议
贵阳
英文
283-296
2015-09-01（万方平台首次上网日期，不代表论文的发表时间）