Department of Infectious Disease, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Division of Liver Disease, The Infectious Disease Hospital of Handan City, Handan, Hebei, China.
Sci Rep. 2017 Jan 9;7:40404. doi: 10.1038/srep40404.
Noninvasive serum markers for assessment of liver fibrosis in chronic hepatitis B (CHB) patients have not been well-studied. The present study was to evaluate the predictive value of serum interferon gamma-inducible protein-10 (IP-10/CXCL10) and the interferon (IFN)-γ/interleukin (IL)-4 ratio for liver fibrosis progression in CHB patients. A total of 180 CHB patients were categorized into four groups: no fibrosis, mild fibrosis, moderate fibrosis, and severe fibrosis. Serum and intrahepatic levels of IP-10, IFN-γ, and IL-4 were examined, from which the IFN-γ/IL-4 ratio was calculated. We found that the serum IP-10 levels were positively correlated with the severity of liver fibrosis, whereas the IFN-γ/IL-4 ratio was negatively associated with the progression of hepatic fibrosis. Multivariate logistic regression analysis revealed that the serum IP-10 was an independent predictor for significant fibrosis. For predicting significant fibrosis, the IP-10 cut-off value of 300 ng/mL had a sensitivity of 92.7% and a specificity of 68.6%. When the IP-10 level was combined with the IFN-γ/IL-4 ratio, the specificity and positive predictive value were 93.8% and 94.6%, respectively; thus, the discriminatory ability was much improved. In conclusion, the serum IP-10 level and the IFN-γ/IL-4 ratio have great potential to predict significant fibrosis among CHB patients.
慢性乙型肝炎(CHB)患者的肝纤维化无创性血清标志物研究甚少。本研究旨在评估血清干扰素γ诱导蛋白-10(IP-10/CXCL10)和干扰素(IFN)-γ/白细胞介素(IL)-4 比值对 CHB 患者肝纤维化进展的预测价值。共纳入 180 例 CHB 患者,分为无纤维化、轻度纤维化、中度纤维化和重度纤维化四组。检测血清和肝内 IP-10、IFN-γ 和 IL-4 水平,并计算 IFN-γ/IL-4 比值。结果显示,血清 IP-10 水平与肝纤维化严重程度呈正相关,而 IFN-γ/IL-4 比值与肝纤维化进展呈负相关。多因素 logistic 回归分析显示,血清 IP-10 是显著纤维化的独立预测因子。预测显著纤维化时,IP-10 截断值为 300ng/ml 时,敏感性为 92.7%,特异性为 68.6%。当 IP-10 水平与 IFN-γ/IL-4 比值相结合时,特异性和阳性预测值分别为 93.8%和 94.6%,因此,诊断能力大大提高。结论:血清 IP-10 水平和 IFN-γ/IL-4 比值有望成为预测 CHB 患者显著纤维化的指标。