Department of Central Clinical Laboratory, Osaka City University Hospital, Osaka, Japan.
Department of Hepatology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
J Gastroenterol Hepatol. 2021 Jan;36(1):217-224. doi: 10.1111/jgh.15114. Epub 2020 Jun 12.
The evaluation of liver fibrosis in patients with chronic hepatitis C virus (HCV) infection is important as it is a risk factor for hepatocellular carcinoma. In the recent years, autotaxin (ATX) has been established as a new noninvasive biomarker to predict liver fibrosis. However, antiviral treatment has been reported to decrease serum ATX, but it is unclear whether posttreatment ATX levels reflect liver fibrosis. In the present study, the correlation between ATX and liver fibrosis in pretreatment and posttreatment patients with HCV infection was analyzed.
A total of 199 samples from 136 patients with HCV infection who had undergone hepatic biopsy before and/or after antiviral treatment at Osaka City University Hospital were used. Posttreatment patients included 38 interferon-treated patients and 80 interferon-free direct-acting antiviral-treated patients; all patients achieved a sustained virological response (SVR). Serum ATX levels were determined by enzyme immunoassay with an AIA-2000 analyzer.
Serum ATX levels were largely correlated with liver fibrosis stage in patients with HCV infection before and after antiviral treatment. The measured values decreased even in similar liver fibrosis stages after treatment. The area under the receiver operating characteristic curve for the ability of ATX to diagnose above F2 stage before treatment was 0.81 (both male and female) and that after achieving SVR, it was 0.71 (male) and 0.72 (female).
Serum ATX levels were correlated with histological liver fibrosis stage after achieving SVR. However, separate cutoff values before and after antiviral therapy should be established.
评估慢性丙型肝炎病毒（HCV）感染患者的肝纤维化程度非常重要，因为它是肝细胞癌的一个风险因素。近年来，自分泌酶（ATX）已被确立为一种新的非侵入性生物标志物，用于预测肝纤维化。然而，抗病毒治疗已被报道可降低血清 ATX，但尚不清楚治疗后 ATX 水平是否反映肝纤维化。本研究分析了 HCV 感染患者治疗前后 ATX 与肝纤维化之间的相关性。
本研究共使用了 136 例在大阪市立大学医院接受肝活检的 HCV 感染患者的 199 份样本，其中包括 38 例干扰素治疗患者和 80 例无干扰素直接作用抗病毒治疗患者；所有患者均达到持续病毒学应答（SVR）。采用 AIA-2000 分析仪通过酶免疫测定法测定血清 ATX 水平。
治疗前后，血清 ATX 水平与 HCV 感染患者的肝纤维化分期高度相关。即使在治疗后相似的肝纤维化分期，测定值也会下降。治疗前 ATX 诊断 F2 以上分期的能力的受试者工作特征曲线下面积为 0.81（男、女），而 SVR 后，男性为 0.71，女性为 0.72。
在实现 SVR 后，血清 ATX 水平与组织学肝纤维化分期相关。然而，应在抗病毒治疗前后建立单独的截止值。
