Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
J Pediatr Surg. 2021 Jul;56(7):1174-1178. doi: 10.1016/j.jpedsurg.2021.03.034. Epub 2021 Apr 9.
Portoenterostomy is the standard treatment for biliary atresia (BA) that reduces jaundice in two thirds of cases. However, progressive liver fibrosis is common, leading to cirrhosis in most patients. Autotaxin is a new marker for the progression of hepatic fibrosis. We examined the relationship between serum autotaxin levels and liver histological findings in patients with BA.
BA patients with native livers were identified in our hospital. Patients underwent protocol liver biopsies every 1 to 5 years, and liver fibrosis was evaluated based on the METAVIR score. Serum autotaxin levels were compared with the last available pathological findings.
Thirty-five patients were included and the median age was 10.6 years. Serum autotaxin levels was median 1.6 mg/L. The mean autotaxin level was 1.08 mg/L in F0, 1.07 mg/L in F1, 0.95 mg/L in F2, 2.17 mg/L in F3, and 2.50 mg/L in F4; it was significantly higher in F4 than in F0-F2 (P<0.0024). For predicting cirrhosis (F4) and advanced liver fibrosis (≥F3), autotaxin had the almost same areas under the curve (AUCs 0.78 and 0.90, respectively) as well as M2BPGi.
Autotaxin levels could be used to evaluate the status of native liver fibrosis.
肠吻合术是治疗胆道闭锁(BA)的标准方法,可使三分之二的病例黄疸消退。然而,进行性肝纤维化很常见,导致大多数患者发生肝硬化。自分泌酶是肝纤维化进展的新标志物。我们研究了 BA 患者血清自分泌酶水平与肝组织学发现之间的关系。
在我院确定了具有原生肝脏的 BA 患者。患者每 1-5 年接受一次方案性肝活检,并根据 METAVIR 评分评估肝纤维化。将血清自分泌酶水平与最后一次可用的病理发现进行比较。
共纳入 35 例患者,中位年龄为 10.6 岁。血清自分泌酶水平中位数为 1.6mg/L。F0 期平均自分泌酶水平为 1.08mg/L,F1 期为 1.07mg/L,F2 期为 0.95mg/L,F3 期为 2.17mg/L,F4 期为 2.50mg/L;F4 期明显高于 F0-F2 期(P<0.0024)。对于预测肝硬化(F4)和晚期肝纤维化(≥F3),自分泌酶的曲线下面积(AUC)与 M2BPGi 几乎相同(分别为 0.78 和 0.90)。
自分泌酶水平可用于评估原生肝纤维化的状态。