title: Serum hyaluronic acid as a marker of hepatic fibrosis.
abstract: OBJECTIVE
  To determine the serum hyaluronic acid (HA) levels as biochemical marker of hepatic fibrosis and cirrhosis and correlate it with the degree of hepatic fibrosis and cirrhosis.
  
  
  METHODS
  Comparative cross-sectional study.
  
  
  METHODS
  The Armed Forces Institute of Pathology, Rawalpindi from September 2003 to August 2004.
  
  
  METHODS
  This study was performed on 100 patients of chronic liver disease whose liver biopsies had been carried out. Fifty healthy controls were also included in the study. Routine liver function tests, hepatitis serology and serum hyaluronic acid levels were carried out on patients and controls.
  
  
  RESULTS
  Liver biopsy of 100 patients revealed that 21 were in stage 0 fibrosis, 38 in stage 1 fibrosis, 26 in stage 3 fibrosis and 15 in stage 4 fibrosis. Mean Serum HA (mean+/-SD) concentration in patients were 189+/-98 mg/L vs. 21+/-10 mg/L of healthy controls. The difference observed was statistically significant (p < 0.001). Patients in stage 4 fibrosis had significantly higher (p < 0.001) mean serum HA concentration as compared to other stages of liver fibrosis. Diagnostic accuracy of serum HA at marginally elevated level of 60 mg/L determined the sensitivity 78.4 %, specificity 80.9%, positive predicted value 93.9% and negative predicted value of 50%.
  
  
  CONCLUSIONS
  Serum HA is a useful non-invasive marker of liver fibrosis. There is a strong positive correlation between serum HA levels and degree of liver fibrosis. The concentration of serum HA rises according to progression of liver fibrosis and levels are highest in patients with liver cirrhosis.
authors.affiliation: Department of Pathology, CMH, Rahim Yar Khan. jawwad186@yahoo.com
authors.forename: Jawwad Anis
authors.initials: JA
authors.lastname: Khan
authors.forename: Farooq Ahmad
authors.initials: FA
authors.lastname: Khan
authors.forename: Muhammad
authors.initials: M
authors.lastname: Dilawar
authors.forename: Aamir
authors.initials: A
authors.lastname: Ijaz
authors.forename: Nadeem Akbar
authors.initials: NA
authors.lastname: Khan
authors.forename: Tariq
authors.initials: T
authors.lastname: Mehmood
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D006820:Hyaluronic Acid