title: Serum markers of liver fibrosis and histologic severity of fibrosis in resected liver.
abstract: OBJECTIVE
  Serum concentrations of the 7S fragment of type IV collagen (7S collagen), amino-terminal propeptide of type III procollagen (PIIIP), and hyaluronic acid (HA) have been reported to serve as serologic markers of liver fibrosis in hepatitis and cirrhosis. We investigated whether these fibrosis markers reliably reflect histologic changes in the livers of patients with hepatocellular carcinoma.
  
  
  METHODS
  Subjects included 165 patients undergoing liver resection for hepatocellular carcinoma. Most were seropositive for chronic hepatitis B or C. Histopathologic changes in liver tissue resected with the tumor were scored according to Knodell's histologic activity index. Serum was sampled for assays shortly before surgery.
  
  
  RESULTS
  Significant correlations were found between hepatitis activity score and 7S collagen, PIIIP, and HA. Concentrations of 7S collagen differed significantly between activity grades, but differences were not significant for PIIIP or HA. Significant correlations were found between fibrosis staging score and all these three markers. When patients were divided according to activity grade, 7S collagen showed stronger correlation with fibrosis staging score than did PIIIP or HA.
  
  
  CONCLUSIONS
  The 7S collagen fragment correlated more strongly than PIIIP or HA with stage and activity grade in patients with hepatocellular carcinoma. However, overlapping of results between histologically defined groups appeared to limit clinical diagnostic usefulness of all markers in individual patients.
authors.affiliation: Second Department of Surgery, Osaka City University Medical School, Osaka, Japan. tsukamotot@msic.med.osaka-cu.ac.jp
authors.forename: Tadashi
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Ikebe
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemura
authors.forename: Taichi
authors.initials: T
authors.lastname: Shuto
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hirohashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kinoshita
mesh_terms: D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology / Q000601:surgery; D024141:Collagen Type IV / Q000097:blood; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology*; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D024141:Collagen Type IV; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide; D006820:Hyaluronic Acid