Murawaki Y, Ikuta Y, Koda M, Yamada S, Kawasaki H
Second Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
J Hepatol. 1996 Feb;24(2):148-54. doi: 10.1016/s0168-8278(96)80023-7.
BACKGROUND/AIMS: A competitive radioimmunoassay for serum 7S fragment of type IV collagen (7S collagen) using a polyclonal antibody against 7S collagen and a sandwich enzyme immunoassay for serum central triple-helix of type IV collagen (IV collagen) using two monoclonal antibodies against the pepsin-solubilized type IV collagen may be used as diagnostic aids for liver fibrosis in clinical medicine. We compared the clinical usefulness for assessing liver fibrosis of serum 7S collagen and IV collagen tests in chronic viral liver diseases, and also examined the elution pattern of 7S collagen- and IV collagen-related antigens in serum by gel filtration analysis.
Serum 7S collagen and IV collagen levels were assayed in 151 patients with chronic viral liver disease and 30 healthy control subjects.
Gel filtration on the Sephacryl S400HR column revealed that the 7S collagen antigenicity in serum was heterogeneous, whereas the IV collagen antigen in serum was uniform in size. Serum levels of 7S collagen and IV collagen showed increases closely correlated with the severity of liver disease. The abnormal percentage of 7S collagen in three patient groups was similar to that of IV collagen in the corresponding groups. Serum 7S collagen and IV collagen levels were strongly correlated with the histological degree of liver fibrosis; the correlation coefficients were r = +0.675 for 7S collagen and r = +0.665 for IV collagen. When we assessed the ability of each test to detect cirrhosis with a receiver operating curve, the serum 7S collagen test was a slightly better marker than the serum IV collagen test. For the detection of cirrhosis, serum 7S collagen was 83% sensitive and 88% specific at a cutoff value of 9 ng/ml, and serum IV collagen was 80% sensitive and 81% specific at a cutoff value of 160 ng/ml.
These findings suggested that serum 7S collagen and IV collagen tests are similarly useful for assessing liver fibrosis in patients with chronic viral liver disease, although the former is slightly better for diagnosing cirrhosis than the latter.
背景/目的：使用抗IV型胶原7S片段（7S胶原）的多克隆抗体进行血清7S胶原的竞争性放射免疫测定，以及使用两种抗胃蛋白酶溶解的IV型胶原的单克隆抗体进行血清IV型胶原中央三螺旋（IV胶原）的夹心酶免疫测定，可作为临床医学中肝纤维化的诊断辅助手段。我们比较了血清7S胶原和IV胶原检测在慢性病毒性肝病中评估肝纤维化的临床实用性，并通过凝胶过滤分析研究了血清中7S胶原和IV胶原相关抗原的洗脱模式。
检测了151例慢性病毒性肝病患者和30例健康对照者的血清7S胶原和IV胶原水平。
在Sephacryl S400HR柱上进行凝胶过滤显示，血清中的7S胶原抗原性具有异质性，而血清中的IV胶原抗原大小均一。血清7S胶原和IV胶原水平的升高与肝病严重程度密切相关。三个患者组中7S胶原的异常百分比与相应组中IV胶原的异常百分比相似。血清7S胶原和IV胶原水平与肝纤维化的组织学程度密切相关；7S胶原的相关系数r = +0.675，IV胶原的相关系数r = +0.665。当我们用受试者工作曲线评估每项检测诊断肝硬化的能力时，血清7S胶原检测比血清IV胶原检测略好。对于肝硬化的检测，血清7S胶原在临界值为9 ng/ml时敏感性为83%，特异性为88%，血清IV胶原在临界值为160 ng/ml时敏感性为80%，特异性为81%。
这些发现表明，血清7S胶原和IV胶原检测在评估慢性病毒性肝病患者的肝纤维化方面同样有用，尽管前者在诊断肝硬化方面比后者略好。
