title: Connective tissue growth factor in serum as a new candidate test for assessment of hepatic fibrosis.
abstract: BACKGROUND
  No reliable, cost-effective serum test is available for assessment of liver fibrogenesis, the most serious complication of chronic inflammatory liver diseases (CLD). In sera of patients with CLD, we determined the concentration of connective tissue growth factor (CTGF), a secreted downstream mediator of the potent fibrogenic cytokine transforming growth factor beta (TGF-beta).
  
  
  METHODS
  We studied 83 patients with CLD (17 with chronic hepatitis, 16 with histologically proven fibrosis, and 50 with cirrhosis) and 74 healthy individuals. Serum CTGF was measured by use of a sandwich immunoassay.
  
  
  RESULTS
  The mean concentration of CTGF was highest in the fibrosis group (5.2-fold) and in the chronic viral hepatitis group (4.3-fold) but lower in those patients with fully developed cirrhosis. The area under the ROC curve (AUC) of CTGF for fibrosis vs control was 0.955 (95% confidence interval, 0.890-0.987). The CTGF/platelet ratio increased the detection limit for cirrhosis from 84% to 92% and the specificity from 85% to 87.5% (cutoff for CTGF was 364 microg/L, ratio 2.05).
  
  
  CONCLUSIONS
  CTGF in serum is a candidate marker of ongoing fibrogenesis in chronic liver diseases.
authors.affiliation: Institute of Clinical Chemistry and Pathobiochemistry, Central Laboratory, Institute of Medical Statistics, RWTH University Hospital, Aachen, Germany. gressner@twth-aachen.de
authors.forename: Axel M
authors.initials: AM
authors.lastname: Gressner
authors.forename: Eray
authors.initials: E
authors.lastname: Yagmur
authors.forename: Birgit
authors.initials: B
authors.lastname: Lahme
authors.forename: Olav
authors.initials: O
authors.lastname: Gressner
authors.forename: Sven
authors.initials: S
authors.lastname: Stanzel
mesh_terms: D055513:Connective Tissue Growth Factor; D005260:Female; D006519:Hepatitis, Alcoholic / Q000150:complications; D006521:Hepatitis, Chronic / Q000150:complications; D006801:Humans; D017874:Immediate-Early Proteins / Q000097:blood*; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D044967:Serum
chemical_list: C526317:CCN2 protein, human; D017874:Immediate-Early Proteins; D036341:Intercellular Signaling Peptides and Proteins; D055513:Connective Tissue Growth Factor