Evaluation of serum aminoterminal procollagen type III propeptide as an index of portal hypertension and esophageal varices in chronic liver diseases.

The concentration of the aminoterminal propeptide of type III procollagen (P-III-P) was determined in serum of cubital vein and hepatic vein of patients with various types of chronic liver diseases (n = 111) and correlated with the portal venous pressure and with the degree of esophageal varices. The P-III-P level in all chronic liver diseases was correlated (rS 0.542, p less than 0.001) with the portal venous pressure, but in liver fibrotic subjects (n = 29) this correlation (rS 0.310) was not significant, in liver cirrhosis (n = 30) the respective correlation was found to be weak (rS 0.333, p less than 0.05) and similar to that in patients with unspecified chronic liver diseases (n = 52) (rS 0.425, p less than 0.01). Sensitivity and specificity of P-III-P at a cut-off concentration of 12 ng/ml for portal hypertension (portal vein pressure 5 mm Hg) are 0.93 and 0.42, respectively, the diagnostic efficiency is 0.67. Predictive values at the same cut-off level of P-III-P and an assumed prevalence of portal hypertension of 50% are 0.62 and 0.85 for the positive and negative test result, respectively. The level of P-III-P is not related to the degree of esophageal varices. The mean P-III-P concentration in the hepatic vein was found to be significantly (p less than 0.001) higher (about 35%) than that in the cubital vein. It is concluded that P-III-P is not an useful parameter for diagnosis of portal hypertension and monitoring of portal vein pressure and of the degree of esophageal varices.