Coskun Yusuf, Yuksel Ilhami
Department of Gastroenterology, University of Health Sciences, Diskapı Yildirim Beyazit Training and Research Hospital, İrfan Baştuğ Cad. Dışkapı, Ankara, Turkey.
Department of Gastroenterology, Ankara Yildirim Beyazit University, School of Medicine, Ankara, Turkey.
Wien Klin Wochenschr. 2021 May;133(9-10):432-440. doi: 10.1007/s00508-020-01732-8. Epub 2020 Sep 14.
Non-invasive methods are being developed to evaluate liver fibrosis. In this study, we aimed to evaluate the diagnostic performance of rheumatoid factor (RF) to predict liver fibrosis in chronic hepatitis B (CHB).
A total of 235 non-arthritic, treatment-naive patients with hepatitis B virus (HBV) were enrolled in this study. The RF level was analyzed concurrently with HBV-DNA and routine biochemical tests. The liver biopsies were scored by using the Knodell modified histology activity index (HAI) and the Ishak fibrosis score.
Mean age, ALT, AST, ALP, GGT, INR, and HBV-DNA levels were significantly higher, and mean albumin and platelet levels were significantly lower in the RF positive group than the RF negative group. Liver biopsy was performed in 112 (47.66%) patients, and the RF positivity rate was 18 (15.38%) in the infection subgroup and 73 (61.86%) in the hepatitis subgroup. Along with the RF positivity rate, the fibrosis and HAI scores were also increased. A high fibrosis score is associated with a high RF positivity rate.
In the current study, we found that there was a significant positive correlation between RF and liver fibrosis stage in patients with CHB. The RF that is easily obtained with low cost may be considered as an alternative biomarker for predicting liver fibrosis in CHB.
正在研发非侵入性方法来评估肝纤维化。在本研究中，我们旨在评估类风湿因子（RF）预测慢性乙型肝炎（CHB）肝纤维化的诊断性能。
本研究共纳入235例未患关节炎且未接受过治疗的乙型肝炎病毒（HBV）患者。同时分析RF水平与HBV-DNA及常规生化检查结果。采用Knodell改良组织学活动指数（HAI）和Ishak纤维化评分对肝活检标本进行评分。
RF阳性组的平均年龄、ALT、AST、ALP、GGT、INR和HBV-DNA水平显著高于RF阴性组，而平均白蛋白和血小板水平显著低于RF阴性组。112例（47.66%）患者进行了肝活检，感染亚组的RF阳性率为18例（15.38%），肝炎亚组为73例（61.86%）。随着RF阳性率的升高，纤维化和HAI评分也升高。高纤维化评分与高RF阳性率相关。
在本研究中，我们发现CHB患者的RF与肝纤维化分期之间存在显著正相关。易于获得且成本低廉的RF可被视为预测CHB肝纤维化的替代生物标志物。
