Chiara Rosso1, Gian Paolo Caviglia2, Maria Lorena Abate2, Ester Vanni3, Lavinia Mezzabotta3, Giovanni Antonio Touscoz4, Antonella Olivero2, Andrea Marengo3, Mario Rizzetto3, Elisabetta Bugianesi3, Antonina Smedile3. 1. Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy. Electronic address: crosso3@cittadellasalute.to.it. 2. Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy. 3. Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy; Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy. 4. Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy.
Abstract
BACKGROUND: The combination of non-invasive markers for the detection of fibrosis in patients with chronic liver diseases is still a matter of debate. AIMS: To test the performance of cytokeratin18-Aspartate396 alone or in combination with transient elastography as a marker of fibrosis, compared to liver biopsy as gold standard. METHODS: In 259 prospectively enrolled patients with chronic liver diseases, clinical, biochemical, and histological features were assessed. Serum cytokeratin18-Aspartate396 and Fibroscan were performed within 6 months prior to liver biopsy. RESULTS: Cytokeratin18-Aspartate396 levels predicted both significant and advanced fibrosis in non-alcoholic fatty liver disease group, correctly identifying 83.7% and 80.8% of cases, respectively. Liver stiffness performed best in predicting severe fibrosis in patients with chronic viral infection, correctly identifying 78.7% of chronic hepatitis B and 88.6% of chronic hepatitis C subjects. The combination of cytokeratin18-Aspartate396 and liver stiffness improved their diagnostic performance for the detection of significant and advanced fibrosis in non-alcoholic fatty liver disease group, only (sensitivity=78.3%, specificity=90.7%; sensitivity=91.7%, specificity=71.6%, respectively). CONCLUSION: Cytokeratin18-Aspartate396 and liver stiffness can improve the non-invasive prediction of significant and advanced fibrosis in patients with non-alcoholic fatty liver disease, while in hepatitis B and C virus infected patients their combined use had no advantage over the diagnostic accuracy of transient elastography alone.
BACKGROUND: The combination of non-invasive markers for the detection of fibrosis in patients with chronic liver diseases is still a matter of debate. AIMS: To test the performance of cytokeratin18-Aspartate396 alone or in combination with transient elastography as a marker of fibrosis, compared to liver biopsy as gold standard. METHODS: In 259 prospectively enrolled patients with chronic liver diseases, clinical, biochemical, and histological features were assessed. Serum cytokeratin18-Aspartate396 and Fibroscan were performed within 6 months prior to liver biopsy. RESULTS:Cytokeratin18-Aspartate396 levels predicted both significant and advanced fibrosis in non-alcoholic fatty liver disease group, correctly identifying 83.7% and 80.8% of cases, respectively. Liver stiffness performed best in predicting severe fibrosis in patients with chronic viral infection, correctly identifying 78.7% of chronic hepatitis B and 88.6% of chronic hepatitis C subjects. The combination of cytokeratin18-Aspartate396 and liver stiffness improved their diagnostic performance for the detection of significant and advanced fibrosis in non-alcoholic fatty liver disease group, only (sensitivity=78.3%, specificity=90.7%; sensitivity=91.7%, specificity=71.6%, respectively). CONCLUSION:Cytokeratin18-Aspartate396 and liver stiffness can improve the non-invasive prediction of significant and advanced fibrosis in patients with non-alcoholic fatty liver disease, while in hepatitis B and C virus infectedpatients their combined use had no advantage over the diagnostic accuracy of transient elastography alone.
Authors: Alshaima Alhinai; Afsheen Qayyum-Khan; Xun Zhang; Patrick Samaha; Peter Metrakos; Marc Deschenes; Philip Wong; Peter Ghali; Tian-Yan Chen; Giada Sebastiani Journal: World J Hepatol Date: 2021-12-27