Murawaki Y, Ikuta Y, Koda M, Kawasaki H
Second Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
Hepatology. 1994 Oct;20(4 Pt 1):780-7. doi: 10.1002/hep.1840200403.
To assess the clinical value of serum biochemical markers, the aminoterminal peptide of type III procollagen, type IV collagen 7S domain, the central triple-helix of type IV collagen and tissue inhibitor of metalloproteinases, as a marker of hepatic fibrosis, we measured these four serum markers in 132 patients with chronic viral liver disease and compared these serum markers with liver histological findings. Serum levels of these markers increased closely with the progress of liver disease, and the abnormal percentages of type III procollagen peptide, type IV collagen 7S domain, central triple-helix of type IV collagen and tissue inhibitor of metalloproteinases in patients with cirrhosis were 97%, 95%, 83% and 48%, respectively. These four serum markers strongly correlated with the histological degree of periportal with or without bridging hepatocellular necrosis and of liver fibrosis and correlated weakly with the degree of intralobular degeneration and focal necrosis and the degree of portal inflammation. The correlation coefficients of serum type IV collagen 7S domain with periportal with or without bridging hepatocellular necrosis and with liver fibrosis were the highest among these four serum markers, suggesting that serum type IV collagen 7S domain is the most valuable diagnostic marker to assess the degree of liver fibrosis in chronic viral liver disease. When we assessed the ability of each serum marker to detect cirrhosis with a receiver operating curve, the best test was type IV collagen 7S domain, and the second best was type III procollagen peptide.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估血清生化标志物，即III型前胶原氨基端肽、IV型胶原7S结构域、IV型胶原中央三螺旋结构和金属蛋白酶组织抑制剂作为肝纤维化标志物的临床价值，我们检测了132例慢性病毒性肝病患者的这四种血清标志物，并将这些血清标志物与肝脏组织学检查结果进行比较。这些标志物的血清水平随肝病进展而密切升高，肝硬化患者中III型前胶原肽、IV型胶原7S结构域、IV型胶原中央三螺旋结构和金属蛋白酶组织抑制剂的异常百分比分别为97%、95%、83%和48%。这四种血清标志物与伴有或不伴有桥接性肝细胞坏死的汇管区组织学程度及肝纤维化程度密切相关，与小叶内变性和局灶性坏死程度及门脉炎症程度相关性较弱。在这四种血清标志物中，血清IV型胶原7S结构域与伴有或不伴有桥接性肝细胞坏死的汇管区及肝纤维化的相关性系数最高，提示血清IV型胶原7S结构域是评估慢性病毒性肝病肝纤维化程度最有价值的诊断标志物。当我们用受试者工作特征曲线评估每种血清标志物检测肝硬化的能力时，最佳检测指标是IV型胶原7S结构域，其次是III型前胶原肽。（摘要截短至250字）
