Montalto G, Soresi M, Aragona F, Tripi S, Carroccio A, Anastasi G, Magliarisi C, Barresi E, Notarbartolo A
Istituto di Medicina Interna e Geriatria, Università di Palermo, Italia.
Presse Med. 1996 Jan 20;25(2):59-62.
We measured serum concentrations of the N-terminal peptide of type III procollagen (PIIIP) and laminin (Lam-P1) in patients with chronic viral liver disease in the various stages of the clinical course, to judge their value in assessing liver fibrogenesis, and also compared them with a number of liver function tests and histological scores of inflammation and fibrosis.
Twenty-nine patients with chronic persistent hepatitis, 39 with chronic active hepatitis and 42 with liver cirrhosis were studied. The control group was composed of 45 healthy blood donors. Serum PIIIP and Lamp-P1 were determined by radioimmunoassay; hepatic function was measured by routine assay; liver fibrosis and inflammation were graded on a 0-3 score scale.
A significantly higher increase in serum levels of PIIIP and Lam-P1 was found in the liver cirrhosis group compared with the other groups (p < 0.05). Serum PIIIP correlated with transaminase levels in the chronic active hepatitis group and with gammaglobulin and total bilirubin in the liver cirrhosis group. A positive correlation was found only with gammaglobulin and total bilirubin in the cirrhosis group. A positive correlation was found between serum PIIIP levels and the rating scale of liver necrosis. In contrast, for Lam-P1 values, a correlation with the rating scale of necrosis and fibrosis was found.
Our findings confirmed the increase of PIIIP and Lamp-P1 in chronic viral liver disease, but because of the frequent overlap values, they cannot be used as substitutes for liver biopsy for diagnosis. The correlations with the histological findings indicate that these two markers can be used during the follow-up of patients receiving anti-inflammatory or anti-fibrotic treatment.
我们测定了慢性病毒性肝病患者在临床病程各阶段血清中III型前胶原N端肽(PIIIP)和层粘连蛋白(Lam-P1)的浓度,以判断其在评估肝纤维化形成中的价值,并将它们与多项肝功能检查以及炎症和纤维化的组织学评分进行比较。
对29例慢性持续性肝炎患者﹑39例慢性活动性肝炎患者和42例肝硬化患者进行了研究。对照组由45名健康献血者组成。采用放射免疫分析法测定血清PIIIP和Lamp-P1;通过常规检测测定肝功能;肝纤维化和炎症按0-3分制进行分级。
与其他组相比,肝硬化组血清PIIIP和Lam-P1水平显著升高(p<0.05)。在慢性活动性肝炎组中,血清PIIIP与转氨酶水平相关,在肝硬化组中与γ球蛋白和总胆红素相关。在肝硬化组中仅与γ球蛋白和总胆红素呈正相关。血清PIIIP水平与肝坏死评分量表之间呈正相关。相比之下,对于Lam-P1值,发现与坏死和纤维化评分量表相关。
我们的研究结果证实了慢性病毒性肝病中PIIIP和Lamp-P1升高,但由于数值经常重叠,它们不能替代肝活检用于诊断。与组织学结果的相关性表明,这两种标志物可用于接受抗炎或抗纤维化治疗患者的随访。