The levels of serum fibrosis marks and morphometric quantitative measurement of hepatic fibrosis.
OBJECTIVE
To study the relationship between the serum levels of hyaluronic acid (HA), procollagen type III (PCIII), collagen type IV (CIV) and the histological degree of hepatic fibrosis evaluated by image analysis, and the clinical significance of serum HA, PCIII, CIV in the diagnosis of hepatic fibrosis in patients with chronic viral hepatitis.


METHODS
The concentrations of serum HA, PCIII, CIV in 151 patients with chronic viral hepatitis were measured by radioimmunoassay. Liver biopsies were performed in all the patients. Histological sections of 4 microm thickness were stained with Masson's trichrome for fibrosis assessment. Morphometric quantitative measurements for hepatic fibrosis assessment in the 4 microm sections were performed using a fully automated image analysis system. Serum levels of HA, PCIII, and CIV were analyzed at different stages of liver pathology and compared with the morphometric quantitative measurements of hepatic fibrosis.


RESULTS
The serum levels of HA, PCIII, CIV all elevated gradually with the progression of the disease, and all reached the highest in patients with liver cirrhosis. There was a significant difference in the levels of these 3 components between liver cirrhosis group and the other groups (P<0.05). They all increased steadily with the histological stages of hepatic fibrosis, and reached the highest levels in stage IV. The serum levels of HA, PCIII, CIV were all positively correlated with the histological stages of liver sections and the morphometric measurement (P<0.001). The coefficients with stages were 0.694, 0.493, 0.552 (P<0.001), respectively and with surface density of total collagen on liver biopsy sections by image analysis were 0.715, 0.595, 0.573 (P<0.001), respectively.


CONCLUSIONS
The serum levels of HA, PCIII, CIV were in consistent with the degree of hepatic fibrosis, and the determination of these marks is valuable for detecting hepatic fibrosis.
Xie
Shi-Bin
SB
Department of Infectious Diseases, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China. xieshib@hotmail.com
Yao
Ji-Lu
JL
Zheng
Shu-Sen
SS
Yao
Chun-Lan
CL
Zheng
Rong-Qin
RQ
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002648:Child; D003094:Collagen / Q000378:metabolism; D024061:Collagen Type III / Q000097:blood*; D024141:Collagen Type IV / Q000097:blood*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D007091:Image Processing, Computer-Assisted; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D014018:Tissue Distribution
D015415:Biomarkers; D024061:Collagen Type III; D024141:Collagen Type IV; D006820:Hyaluronic Acid; D003094:Collagen