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Vol. 16. Issue 1.
Pages 9-14 (January - February 2012)
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Vol. 16. Issue 1.
Pages 9-14 (January - February 2012)
Open Access
Role of hyaluronic acid and laminin as serum markers for predicting significant fibrosis in patients with chronic hepatitis B
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Feng Lia,
Corresponding author
willim118@hotmail.com

Corresponding author at: Affiliated Hospital of Nantong University, Nantong Xisi Road 20#, Jiang Su, China.
, Chang-Lai Zhub, Hong Zhanga, Hua Huanga, Qun Weia, Xiang Zhua, Xiao-Yang Chenga
a Department of Gastroenterology, Digestive Disease Research Center, Affiliated Hospital of Nantong University, China
b Department of Electron Microscope, Nantong University, China
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Abstract
Objectives

The aim of this study was to evaluate the diagnostic performance of serum HA and LN as serum markers for predicting significant fibrosis in CHB patients.

Methods

Serum HA and LN levels of 87 patients with chronic hepatitis B and 19 blood donors were assayed by RIA. Liver fibrosis stages were determined according to the Metavir scoring-system. The diagnostic performances of all indexes were evaluated by the receiver operating characteristic (ROC) curves.

Results

Serum HA and LN concentrations increased significantly with the stage of hepatic fibrosis, which showed positive correlation with the stages of liver fibrosis (HA: r =0.875, p <0.001; LN: r =0.610, p <0.001). There were significant differences of serum HA and LN levels between F2-4 group in comparison with those in F0-F1 group (p < 0.001) and controls (p < 0.001), respectively. From ROC curves, 185.3ng/mL as the optimal cut-off value of serum HA for diagnosis of significant fibrosis, giving its sensitivity, specificity, PPV, NPV, LR+, LR- and AC of 84.2%, 83.3%, 90.6%, 73.5%, 5.04, 0.19 and 83.9, respectively. While 132.7 ng/mL was the optimal cut-off value of serum LN, the sensitivity, specificity, PPV, NPV, LR+, LR-and AC were 71.9%, 80.0%, 87.2%, 60.0%, 3.59%, 0.35% and 74.7, respectively. Combinations of HA and LN by serial tests showed a perfect specificity and PPV of 100%, at the same time sensitivity declined to 63.2% and LR+ increased to 18.9, while parallel tests revealed a good sensitivity of 94.7%, NPV to 86.4%, and LR- declined to 0.08.

Conclusions

Serum HA and LN concentrations showed positive correlation with the stages of liver fibrosis. Detection of serum HA and LN in predicting significant fibrosis showed good diagnostic performance, which would be further optimized by combination of the two indices. HA and LN would be clinically useful serum markers for predicting significant fibrosis in patients with chronic hepatitis B, when liver biopsy is contraindicated.

Keywords:
Hepatitis B, chronic
Hyaluronic acid
Laminin
Liver
Cirrhosis
ROC curve
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