Fujita Koji, Kuroda Noriyuki, Morishita Asahiro, Oura Kyoko, Tadokoro Tomoko, Nomura Takako, Yoneyama Hirohito, Arai Takeshi, Himoto Takashi, Watanabe Seishiro, Masaki Tsutomu
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Miki 761-0701, Japan.
Department of Clinical Laboratory, Kagawa University Hospital, Miki 761-0701, Japan.
J Clin Med. 2018 Sep 11;7(9):267. doi: 10.3390/jcm7090267.
Chronic liver diseases (CLDs) generally progress from inflammation to fibrosis and finally to carcinogenesis. Staging of liver fibrosis progression is inevitable for the management of CLD patients. The purpose of this study was to compare the diagnostic abilities of Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA-M2BP), Enhanced liver fibrosis (ELF) score, Fibrosis-4 index, and AST to platelet ratio index (APRI) based on histopathological analysis of liver biopsy samples, from patients with positive Hepatitis C Virus (HCV) infection.
Japanese patients with HCV infection who underwent liver biopsy examinations were enrolled in this study. WFA-M2BP levels and ELF scores were calculated using preserved serum samples. The fibrosis staging and activity grading were assessed using a modified METAVIR score.
A total of 122 patients were enrolled; the cohort included 27 patients with stage 1, 66 with stage 2, 20 with stage 3, and nine with stage 4 fibrosis. All four biomarkers distinguished stage 3 and stage 2 fibrosis. ROC curves revealed that all four fibrosis biomarkers presented AUC values greater than 0.8. Each of the four biomarkers in stage 2 was significantly different between the activity grade 1 and 2 groups.
Fib-4 index and APRI were comparable with WFA-M2BP and ELF score in the diagnosis of advanced liver fibrosis in Japanese patients with HCV infection. All four biomarkers of liver fibrosis were influenced by histopathological activity grading, which implies that liver biopsy should be the gold standard to evaluate liver fibrosis staging even though several noninvasive biomarkers have been investigated well.
慢性肝病（CLD）通常从炎症发展为纤维化，最终发展为癌变。肝纤维化进展的分期对于CLD患者的管理是必不可少的。本研究的目的是基于丙型肝炎病毒（HCV）感染阳性患者肝活检样本的组织病理学分析，比较紫藤凝集素阳性Mac-2结合蛋白（WFA-M2BP）、增强肝纤维化（ELF）评分、纤维化-4指数和AST与血小板比值指数（APRI）的诊断能力。
本研究纳入了接受肝活检检查的日本HCV感染患者。使用保存的血清样本计算WFA-M2BP水平和ELF评分。使用改良的METAVIR评分评估纤维化分期和活动分级。
共纳入122例患者；该队列包括27例1期、66例2期、20例3期和9例4期纤维化患者。所有四种生物标志物都区分了3期和2期纤维化。ROC曲线显示，所有四种纤维化生物标志物的AUC值均大于0.8。2期的四种生物标志物在活动1级和2级组之间均有显著差异。
在日本HCV感染患者晚期肝纤维化的诊断中，Fib-4指数和APRI与WFA-M2BP和ELF评分相当。肝纤维化的所有四种生物标志物都受组织病理学活动分级的影响，这意味着即使已经对几种非侵入性生物标志物进行了充分研究，肝活检仍应是评估肝纤维化分期的金标准。
