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[Study on the influence factors of the serum fibrosis markers]
Wei-min Cai1, Jun Tao, Hong-lei Weng
1Institute of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
Insights
Serum fibrosis markers in chronic hepatitis B patients do not always correlate with liver fibrosis stage. However, they show a strong link with inflammation grade and altered liver function tests.
Area of Science:
- Hepatology
- Biochemistry
- Medical Diagnostics
Context:
- Chronic hepatitis B (CHB) is a significant global health concern.
- Accurate staging of liver fibrosis is crucial for CHB management.
- Non-invasive biomarkers are sought to complement liver biopsy.
Purpose:
- To analyze factors influencing four serum fibrosis markers: hyaluronic acid (HA), procollagen type III (PCIII), laminin (LN), and collagen type IV (CIV).
- To investigate the correlation between these serum markers, liver fibrosis stage, inflammation grade, and liver function in CHB patients.
Summary:
- Serum levels of HA, PCIII, LN, and CIV were measured in 141 CHB patients.
- A subset of patients (14.16%) showed inconsistency between serum markers and histological fibrosis stage.
- Serum fibrosis markers correlated positively with inflammation grade, not fibrosis stage.
- Significant changes in liver function enzymes (ALT, AST, GGT, globulin) and albumin levels were observed in patients with inconsistent markers.
Impact:
- Highlights the importance of considering inflammation and liver function alongside fibrosis markers for accurate CHB assessment.
- Suggests that serum fibrosis markers may reflect inflammatory activity more than fibrotic changes in some CHB cases.
- Informs the development of more comprehensive non-invasive diagnostic strategies for liver disease.
Objective:
To analyse the factors which influence the four serum fibrosis markers hyaluronic acid (HA), type III procollagen (PCIII), laminin (LN) and type IV collagen (CIV).
Methods:
The levels of serum HA, PCIII, LN and CIV were measured by RIA in 141 patients with chronic hepatitis B (CHB), then the patients were divided into two groups according to the serum fibrosis markers, namely consistent group and inconsistent group. the liver biopsy materials were examined pathomorphologically and liver function was detected by automatic biochemistry analyzer, The interior diameters of the portal vein, the spleen vein and the thickness of the spleen were also measured with ultrasonography.
Results:
16 patients (14.16%) whose serum fibrosis markers were inconsistent with histological stage of liver fibrosis were found. Their serum fibrosis markers were not correlated with staging of liver fibrosis (P>0.05), but were positively correlated with inflammation grade (x(2)=12.07, P<0.05), at same time, the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase(AST), gamma-glutamyltransferase (GGT) and globulin (GLB) decreased obviously, from 89.28 U/L +/- 64.25 U/L to 49.31 U/L +/- 26.75 U/L (t=2.45, P<0.05), 66.10 U/L +/- 42.30 U/L to 40.83 U/L +/- 22.40 U/L (t=2.33, P<0.05), 86.26 U/L +/- 70.36 U/L to 48.99 U/L +/- 29.96 U/L (t=2.08, P<0.05) and 32.13 g/L +/- 5.18 g/L to 28.05 g/L +/- 3.47 g/L (t=3.03, P<0.01) respectively. And the level of albumin (ALB) and the ratio of albumin and globulin (A/G) increased evidently, from 42.34 g/L +/- 4.81 g/L to 46.19 g/L +/- 3.61 g/L (t=3.06, P<0.01) and 1.35 +/- 0.28 to 1.63 +/- 0.26 (t=3.70, P<0.01). But the serum level of alkaline phosphatase (ALP), total bilirubin (TBil), total protein (TP), the width of main portal vein, the width of splenic vein and the thickness of the spleen did not change clearly (P>0.05).
Conclusion:
As diagnostic markers, serum fibrosis markers as well as inflammation grade and liver function should be taken into account.