Collagen IV is a predictor for clinical course in patients with malignant obstructive jaundice.
OBJECTIVE
Increases in the serum extracellular matrix proteins (ECMPs) have been described in studies on cholestasis, therefore we investigated the serum levels of collagen IV, aminoterminal propeptide of type III procollagen, and hyaluronic acid prior to percutaneous transhepatic biliary drainage (PTBD) to evaluate its potential as a predictor for prolonged bilirubin clearance and clinical course in patients with malignant obstructive jaundice (MOJ).


METHODS
Serum levels of ECMPs were prospectively investigated in 42 patients with MOJ prior to PTBD. The study group was subdivided according to the bilirubin clearance, and was also subdivided according to the determined level of collagen IV (cut-off point of 260 ng/mL).


RESULTS
Serum collagen IV was identified as an independent risk factor for prolonged bilirubin clearance (P=0.006). Receiver-operating-characteristic curve analysis revealed that serum collagen IV had a diagnostic accuracy of 79% at the cut-off point of 260 ng/mL. Furthermore, these results indicated that the level of collagen IV is a reliable marker of postoperative liver failure (P=0.029) and predictor of death from liver failure (P=0.02).


CONCLUSIONS
Elevated serum collagen IV is a feature of MOJ commonly associated with prolonged bilirubin clearance, and a useful indicator of clinical course, postoperative morbidity, and mortality in patients with MOJ.
Mizuguchi
Yoshiaki
Y
First Department of Surgery, Nippon Medical School, Tokyo, Japan.
Yoshida
Hiroshi
H
Yokomuro
Shigeki
S
Arima
Yasuo
Y
Mamada
Yasuhiro
Y
Taniai
Nobuhiko
N
Akimaru
Koho
K
Tajiri
Takashi
T
D000368:Aged; D001650:Bile Duct Neoplasms / Q000097:blood*; D001663:Bilirubin / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D024141:Collagen Type IV / Q000097:blood*; D004322:Drainage; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D041781:Jaundice, Obstructive / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood; D011183:Postoperative Complications / Q000097:blood; D011347:Procollagen / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D024141:Collagen Type IV; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide; D006820:Hyaluronic Acid; D001663:Bilirubin