Pecoraro Valentina, Nascimbeni Fabio, Cuccorese Michela, Gabrielli Filippo, Fasano Tommaso, Trenti Tommaso
Complex Structure of Laboratory Medicine, Department of Laboratory Medicine and Pathological Anatomy, AUSL Modena, 41121 Modena, Italy.
Metabolic Medicine Unit, AOU Modena, 41124 Modena, Italy.
Diagnostics (Basel). 2025 Feb 24;15(5):544. doi: 10.3390/diagnostics15050544.
: Golgi protein 73 (GP73) is a transmembrane protein expressed by epithelial cells of the bile duct in the normal liver. High serum levels of GP73 have been detected in patients with acute or chronic liver diseases, MASLD, and its measurement has been suggested as a potential biomarker for liver fibrosis staging. We evaluated the utility of GP73 in the diagnosis of MASLD, MASH, and for liver fibrosis staging. : We performed a literature scoping review to map the current evidence about the accuracy of GP73 in patients with MASLD. We searched in Medline and EMBASE for English studies reporting an AUC value of GP73 in diagnosing MASLD and MASH and evaluating GP73 for fibrosis staging. A narrative synthesis of the evidence was conducted. Moreover, we performed an observational study including 84 patients with MASLD, of which 60 were biopsy-confirmed MASH, and different liver fibrosis stages, and 15 healthy controls. Serum GP73 levels were determined using a chemiluminescent assay and reported as mean and standard deviation (SD). Sensitivity (SE), specificity (SP), the area under the receiver operating characteristic (AUROC) curve, and the optimal cut-off value were calculated. Data were considered statistically significant when < 0.05. Available studies evaluating GP73 in MASLD reported the ability to discriminate MASH from simple steatosis and distinguish patients at different fibrotic stages, but the evidence is still scarce. Our experimental study showed that the serum levels of GP73 were 30 ± 12 ng/mL in MASLD and 32 ± 12 ng/mL in MASH patients and were statistically higher than those of the control group (19 ± 30 ng/mL), increasing from liver fibrosis stage F0 to F4. GP73 levels were significantly higher in patients with significant and advanced fibrosis than controls and no significant fibrosis ( > 0.05). ROC analysis demonstrated that serum GP73 had a good diagnostic potential for MASLD (AUROC 0.85; SE 90%; SP 73%), MASH (AUROC 0.75; SE 82%; SP64%), and significant fibrosis (AUROC 0.7; SE 56%; SP 79%) and was better than other biomarkers for chronic liver diseases. : Serum GP73 could support clinicians in the evaluation of patients with MASH and significant fibrosis.
高尔基体蛋白73（GP73）是一种由正常肝脏中胆管上皮细胞表达的跨膜蛋白。在急性或慢性肝病、代谢相关脂肪性肝病（MASLD）患者中检测到血清GP73水平升高，有人提出检测其水平可作为肝纤维化分期的潜在生物标志物。我们评估了GP73在MASLD、代谢相关脂肪性肝炎（MASH）诊断及肝纤维化分期中的应用价值。我们进行了一项文献综述，以梳理目前关于GP73在MASLD患者中诊断准确性的证据。我们在Medline和EMBASE中检索了英文研究，这些研究报告了GP73在诊断MASLD和MASH以及评估肝纤维化分期方面的曲线下面积（AUC）值。对证据进行了叙述性综合分析。此外，我们进行了一项观察性研究，纳入了84例MASLD患者，其中60例经活检确诊为MASH，且处于不同的肝纤维化阶段，还有15名健康对照者。使用化学发光法测定血清GP73水平，并报告为平均值和标准差（SD）。计算敏感性（SE）、特异性（SP）、受试者操作特征曲线下面积（AUROC）以及最佳截断值。当P<0.05时，数据被认为具有统计学意义。现有评估MASLD患者中GP73的研究报告了其能够区分MASH与单纯性脂肪变性，并区分不同纤维化阶段的患者，但证据仍然不足。我们的实验研究表明，MASLD患者血清GP73水平为30±12 ng/mL，MASH患者为32±12 ng/mL，均显著高于对照组（19±30 ng/mL），且从肝纤维化F0期到F4期逐渐升高。有显著和晚期纤维化的患者GP73水平显著高于对照组以及无显著纤维化的患者（P>0.05）。ROC分析表明，血清GP73对MASLD（AUROC 0.85；SE 90%；SP 73%）、MASH（AUROC 0.75；SE 82%；SP 64%）和显著纤维化（AUROC 0.7；SE 56%；SP 79%）具有良好的诊断潜力，并且优于其他慢性肝病生物标志物。血清GP73可为临床医生评估MASH和显著纤维化患者提供帮助。
