Department of General Internal Medicine, General Medical Center, Kawasaki Medical School, 2-6-1, Nakasange, Kita-ku, Okayama City, 700-8505, Okayama, Japan.
BMC Gastroenterol. 2023 May 10;23(1):143. doi: 10.1186/s12876-023-02786-4.
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. The serum level of soluble CD163 (sCD163), a macrophage activation marker, is associated with liver tissue changes; however, its prognostic value is unknown. Here, we determined the utility of sCD163 as a marker for hepatocellular carcinoma (HCC) and prognostic marker for NAFLD.
This retrospective study obtained data regarding serum sCD163 levels, liver histology, and background factors associated with NAFLD in 287 patients (men/women, 140/147; average age, 53 ± 14 years) with NAFLD who underwent liver biopsy. Repeated liver biopsies of 287 patients with NAFLD (5.0 ± 2.7 years) were compared regarding serum sCD163 levels and liver tissue changes (stage, grade, steatosis, and NAFLD activity score).
Serum sCD163 levels increased with the progression of liver fibrosis and inflammation (both P < 0.05) and were particularly helpful in distinguishing cases of Grade 4 fibrosis (P < 0.001). Levels of sCD163 significantly decreased in patients with NAFLD exhibiting alleviated fibrosis and inflammation (P < 0.05). We could also predict the development of HCC and associated mortality based on serum sCD163 levels at the time of NAFLD diagnosis. Serum sCD163 levels were higher in patients with HCC than in patients without HCC (1074 ± 379 ng/ml vs. 669 ± 261 ng/ml; P < 0.0001), and the same trend was observed for mortality.
The serum sCD163 level reflects the progression of fibrosis and inflammation in liver tissues, showing much promise as a noninvasive biomarker for nonalcoholic steatohepatitis and NAFLD as well as a possible predictor of HCC development and patient prognosis.
非酒精性脂肪性肝病 (NAFLD) 是慢性肝病最常见的原因。血清可溶性 CD163（一种巨噬细胞激活标志物）水平与肝组织变化相关；然而，其预后价值尚不清楚。在此，我们确定了 sCD163 作为肝细胞癌 (HCC) 标志物和 NAFLD 预后标志物的效用。
本回顾性研究纳入了 287 例接受肝活检的 NAFLD 患者（男/女，140/147；平均年龄 53±14 岁）的血清 sCD163 水平、肝组织学和与 NAFLD 相关的背景因素数据。对 287 例 NAFLD 患者（5.0±2.7 年）进行重复肝活检，比较血清 sCD163 水平和肝组织变化（分期、分级、脂肪变性和 NAFLD 活动评分）。
血清 sCD163 水平随肝纤维化和炎症的进展而升高（均 P<0.05），尤其有助于区分 4 级纤维化（P<0.001）。NAFLD 患者纤维化和炎症缓解时，sCD163 水平显著降低（P<0.05）。我们还可以根据 NAFLD 诊断时的血清 sCD163 水平预测 HCC 的发生和相关死亡率。HCC 患者的血清 sCD163 水平高于无 HCC 患者（1074±379 ng/ml 比 669±261 ng/ml；P<0.0001），死亡率也呈同样趋势。
血清 sCD163 水平反映了肝组织纤维化和炎症的进展，有望成为非酒精性脂肪性肝炎和 NAFLD 的非侵入性生物标志物，以及 HCC 发生和患者预后的可能预测指标。
