Serum hyaluronic acid, procollagen type III and IV in histological diagnosis of liver fibrosis.
OBJECTIVE
To assess the significance of serum hyaluronic acid (HA), procollagen type III (PCIII), collagen type IV (CIV) in the histological diagnosis of liver fibrosis.


METHODS
The concentrations of serum HA, PCIII, CIV in 253 patients with chronic liver diseases were measured by radioimmunoassay. Liver biopsies were performed in all patients at the same time. The liver was pathologically evaluated by a pathologist according to a scoring system. Combined with the results of liver pathological diagnosis, the accuracy of serum HA, PCIII, CIV in diagnosing patients with hepatic fibrosis (staging >/=S2) or cirrhosis (S4) was assessed using the receiver operating curve (ROC).


RESULTS
The cutoff values of serum HA, PCIII and CIV for identifying patients with hepatic fibrosis (>/=S2) or cirrhosis (S4) were determined. The cutoff values of serum HA, PCIII and CIV for detecting patients with fibrosis (stage >/=S2) were 90 micrograms/L, 90 micrograms/L, 75 micrograms/L, respectively; their sensitivity (Se) was 80.4%, 82%, 63.1%; their specificity (Spe) was 70.2%, 60.8%, 83.8%; their positive predictive values (PPV) were 86.7%, 83.5%, 90.4%; their negative predictive values (NPV) were 59.8%, 58.4%, 48.4%, respectively. The cutoff values for detecting patients with liver cirrhosis were 210 micrograms/L for HA, 96.2% for Se, 85.3% for Spe, 65.4% for PPV, 98.8% for NPV; 150 micrograms/L for PCIII, 76.4% for Se, 68.7% for Spe, 40.4% for PPV, 91.3% for NPV; 90 micrograms/L for CIV, 80% for Se, 75.8% for Spe, 47.8% for PPV, 93.2% for NPV, respectively.


CONCLUSIONS
Serum HA, PCIII and CIV can be determined for an accurate diagnosis of hepatic fibrosis in various stages. HA is the best for screening liver cirrhosis.
Xie
Shi-Bin
SB
Department of Infectious Diseases, Third Affiliated Hospital, Zhongshan University, Guangzhou 510630, China. xieshib@21cn.com
Yao
Ji-Lu
JL
Zheng
Rong-Qin
RQ
Peng
Xiao-Mou
XM
Gao
Zhi-Liang
ZL
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D024061:Collagen Type III / Q000097:blood*; D024141:Collagen Type IV / Q000097:blood*; D005260:Female; D006521:Hepatitis, Chronic / Q000150:complications / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged
D024061:Collagen Type III; D024141:Collagen Type IV; D006820:Hyaluronic Acid