University Hospital Department of Gastroenterology, University of Crete, Faculty of Medicine, Heraklion, 71100, Crete, Greece.
Eur J Intern Med. 2011 Feb;22(1):77-83. doi: 10.1016/j.ejim.2010.10.002. Epub 2010 Nov 13.
Hyaluronan, leptin, laminin and collagen IV have been used extensively for the assessment of liver fibrosis. The aim of this study was to assay these markers in the peripheral and hepatic vein blood of primary biliary cirrhosis (PBC) patients and to study their ability to discriminate early from advanced disease.
Sera from 62 PBC patients were compared to 60 controls, 44 chronic Hepatitis C, 38 hepatocellular carcinoma and 34 viral cirrhosis patients. Serum from the hepatic vein of 15 cirrhotic PBC patients and 17 patients with viral cirrhosis was also assayed.
All disease groups had significantly increased levels of hyaluronan and collagen IV, compared to controls, while laminin was significantly increased only in viral cirrhosis. Hyaluronan levels were statistically different between early (54.5 ng/ml; 95%CI 27.3-426.9) and late PBC (154.5 ng/ml; 95%CI 55.3-764.4, p<0.05). The area under the curve (AUC) for the identification of late PBC was 0.74 for hyaluronan, 0.63 for leptin, 0.59 for laminin and 0.70 for collagen IV. Hyaluronan had high sensitivity and NPV in identifying late stages of PBC (96% and 90%, respectively). Short term UDCA had no effect on these markers.
No single measurement can differentiate between advanced and early fibrosis in PBC. However serum hyaluronan is a promising single serum marker for longitudinal studies in PBC.
透明质酸、瘦素、层粘连蛋白和胶原 IV 已广泛用于评估肝纤维化。本研究的目的是检测原发性胆汁性肝硬化（PBC）患者外周静脉和肝静脉血中的这些标志物，并研究它们区分早期和晚期疾病的能力。
将 62 例 PBC 患者的血清与 60 例对照、44 例慢性丙型肝炎、38 例肝细胞癌和 34 例病毒性肝硬化患者的血清进行比较。还检测了 15 例肝硬化 PBC 患者和 17 例病毒性肝硬化患者的肝静脉血清。
与对照组相比，所有疾病组的透明质酸和胶原 IV 水平均显著升高，而层粘连蛋白仅在病毒性肝硬化中显著升高。早期（54.5ng/ml；95%CI 27.3-426.9）和晚期 PBC（154.5ng/ml；95%CI 55.3-764.4，p<0.05）患者的透明质酸水平存在统计学差异。透明质酸识别晚期 PBC 的曲线下面积（AUC）为 0.74，瘦素为 0.63，层粘连蛋白为 0.59，胶原 IV 为 0.70。透明质酸在识别 PBC 晚期阶段时具有高灵敏度和阴性预测值（分别为 96%和 90%）。短期 UDCA 对这些标志物没有影响。
没有单一的测量方法可以区分 PBC 的晚期和早期纤维化。然而，血清透明质酸是 PBC 纵向研究的一种很有前途的单一血清标志物。
