Wang Lin, Liu Tianhui, Zhou Jialing, You Hong, Jia Jidong
Liver Research Center, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing, China.
Hepatol Res. 2018 Feb;48(3):E283-E290. doi: 10.1111/hepr.12982. Epub 2017 Oct 11.
Non-invasive assessment of changes in liver fibrosis is still an unmet medical need in the era of antiviral therapy. Therefore, we explore whether chitinase 3-like 1 (CHI3L1), a serum marker of liver fibrosis, can be used as a non-invasive surrogate marker of fibrosis change during treatment.
We correlated serum CHI3L1 levels with liver tissue collagen proportionate area (CPA) in a cohort of 131 patients with chronic hepatitis B (CHB) receiving entecavir-based antiviral therapy for 78 weeks. In addition, we compared this marker with the liver stiffness measurement (LSM). Multivariate regression analyses were undertaken to determine the clinical factors associated with the CHI3L1 levels.
Before treatment, correlation analysis showed that there were positive correlations between CHI3L1 levels and the CPA (r = 0.351, P < 0.001), and between CHI3L1 and LSM (r = 0.412, P < 0.001). After 78 weeks treatment, serum CHI3L1 levels decreased compared with that at baseline (87.8 vs. 69.6 ng/mL, P < 0.001), and CHI3L1 levels were also correlated with CPA (r = 0.293, P = 0.001) and LSM (r = 0.443, P < 0.001). Furthermore, there were positive correlations between the changes in CHI3L1 and CPA (r = 0.366, P<0.001), and changes in CHI3L1 and LSM (r = 0.438, P<0.001). Multivariate regression analyses indicated that CPA values were related with pre- (β = 5.450, P = 0.019) and post-treatment CHI3L1 levels (β = 7.460, P = 0.023).
Chitinase 3-like 1 is not only a useful non-invasive marker for the assessment of liver fibrosis in CHB patients before treatment, but also a potential useful marker for monitoring the change in liver fibrosis during therapy.
在抗病毒治疗时代，对肝纤维化变化进行无创评估仍是一项未满足的医学需求。因此，我们探讨肝纤维化的血清标志物几丁质酶3样1（CHI3L1）是否可作为治疗期间纤维化变化的无创替代标志物。
我们在131例接受基于恩替卡韦的抗病毒治疗78周的慢性乙型肝炎（CHB）患者队列中，将血清CHI3L1水平与肝组织胶原比例面积（CPA）进行关联分析。此外，我们将该标志物与肝脏硬度值（LSM）进行比较。进行多变量回归分析以确定与CHI3L1水平相关的临床因素。
治疗前，相关性分析显示CHI3L1水平与CPA之间存在正相关（r = 0.351，P < 0.001），CHI3L1与LSM之间也存在正相关（r = 0.412，P < 0.001）。治疗78周后，血清CHI3L1水平较基线时下降（87.8对vs. 69.6 ng/mL，P < 0.001），且CHI3L1水平也与CPA（r = 0.293，P = 0.001）和LSM（r = 0.443，P < 0.001）相关。此外，CHI3L1的变化与CPA的变化之间存在正相关（r = 0.366，P < 0.001），CHI3L1的变化与LSM的变化之间也存在正相关（r = 0.438，P < 0.001）。多变量回归分析表明，CPA值与治疗前（β = 5.450，P = 0.019）和治疗后CHI3L1水平（β = 7.460，P = 0.023）相关。
几丁质酶3样1不仅是评估CHB患者治疗前肝纤维化的有用无创标志物，也是监测治疗期间肝纤维化变化的潜在有用标志物。
