血清中结缔组织生长因子作为评估肝纤维化的一项新的候选检测指标。
Connective tissue growth factor in serum as a new candidate test for assessment of hepatic fibrosis.
作者信息
Gressner Axel M, Yagmur Eray, Lahme Birgit, Gressner Olav, Stanzel Sven
机构信息
Institute of Clinical Chemistry and Pathobiochemistry, Central Laboratory, Institute of Medical Statistics, RWTH University Hospital, Aachen, Germany.
出版信息
Clin Chem. 2006 Sep;52(9):1815-7. doi: 10.1373/clinchem.2006.070466. Epub 2006 Jul 20.
BACKGROUND
No reliable, cost-effective serum test is available for assessment of liver fibrogenesis, the most serious complication of chronic inflammatory liver diseases (CLD). In sera of patients with CLD, we determined the concentration of connective tissue growth factor (CTGF), a secreted downstream mediator of the potent fibrogenic cytokine transforming growth factor beta (TGF-beta).
PATIENTS AND METHODS
We studied 83 patients with CLD (17 with chronic hepatitis, 16 with histologically proven fibrosis, and 50 with cirrhosis) and 74 healthy individuals. Serum CTGF was measured by use of a sandwich immunoassay.
RESULTS
The mean concentration of CTGF was highest in the fibrosis group (5.2-fold) and in the chronic viral hepatitis group (4.3-fold) but lower in those patients with fully developed cirrhosis. The area under the ROC curve (AUC) of CTGF for fibrosis vs control was 0.955 (95% confidence interval, 0.890-0.987). The CTGF/platelet ratio increased the detection limit for cirrhosis from 84% to 92% and the specificity from 85% to 87.5% (cutoff for CTGF was 364 microg/L, ratio 2.05).
CONCLUSION
CTGF in serum is a candidate marker of ongoing fibrogenesis in chronic liver diseases.
背景
对于慢性炎症性肝病（CLD）最严重的并发症——肝纤维化的评估，目前尚无可靠且经济有效的血清检测方法。在CLD患者的血清中，我们测定了结缔组织生长因子（CTGF）的浓度，CTGF是强效促纤维化细胞因子转化生长因子β（TGF-β）的一种分泌型下游介质。
患者与方法
我们研究了83例CLD患者（17例慢性肝炎患者、16例经组织学证实有纤维化的患者以及50例肝硬化患者）和74名健康个体。采用夹心免疫分析法测定血清CTGF。
结果
CTGF的平均浓度在纤维化组最高（为对照组的5.2倍），在慢性病毒性肝炎组次之（为对照组的4.3倍），而在完全发展为肝硬化的患者中较低。CTGF用于鉴别纤维化与对照组的ROC曲线下面积（AUC）为0.955（95%置信区间为0.890 - 0.987）。CTGF/血小板比值将肝硬化的检测灵敏度从84%提高到92%，特异性从85%提高到87.5%（CTGF的截断值为364μg/L，比值为2.05）。
结论
血清CTGF是慢性肝病中正在进行的纤维化的一个候选标志物。
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