title: YKL-40 and transient elastography, a powerful team to assess hepatic fibrosis.
abstract: OBJECTIVE
  Transient elastography (TE) is a non-invasive and accurate method for the diagnosis of severe hepatic fibrosis and cirrhosis (F = 3 and F = 4). However, the assessment of significant fibrosis (F = 2) by TE is impaired due to a high variation in the diagnostic accuracy. Within this study, we aim to compare the diagnostic value of TE and experimental biomarkers of liver fibrosis.
  
  
  METHODS
  A total of 55 patients with chronic liver disease of different etiologies were included in the study. Among them, patients with HCV infection represented the largest cohort (n = 25). Liver fibrosis was evaluated according to the Desmet/Scheuer score. All patients received TE. Serum concentrations of YKL-40, hyaluronic acid (HA), Laminin, C-terminal procollagen I peptide, MMP-9, TIMP-1, TIMP-2 and MMP-9/TIMP-1 complex were determined by ELISA.
  
  
  RESULTS
  In the total patient population, areas under the receiver operator characteristic curve (AUROC) for TE were 0.798 (F ≥ 2), 0.880 (F ≥ 3) and 1 (F = 4). Among the serum markers, highest diagnostic accuracies were calculated for YKL-40 for F ≥ 2 (0.792) and F ≥ 3 (0.914) and for YKL-40 and HA for F = 4 (both 0.936). In the subgroup of HCV patients, the following AUROCs for TE were calculated: 0.802 (F ≥ 2), 0.798 (F ≥ 3) and 0.998 (F = 4). YKL-40 exhibited the highest diagnostic accuracy of all biomarkers in the HCV population (0.880, 0.854 and 0.986, respectively).
  
  
  CONCLUSIONS
  YKL-40 is a powerful fibrosis marker with high diagnostic accuracy, in particular in HCV-associated liver disease. Its determination may confirm and improve the diagnostic accuracy of TE especially in early stages of liver fibrosis.
authors: Department of Internal Medicine, Division of Gastroenterology, Justus-Liebig-University Giessen, Giessen, Germany.
authors: Timo
authors: T
authors: Rath
authors: Martin
authors: M
authors: Roderfeld
authors: Can
authors: C
authors: Güler
authors: Christian
authors: C
authors: Wenzel
authors: Jürgen
authors: J
authors: Graf
authors: Frigga
authors: F
authors: Beitinger
authors: Elke
authors: E
authors: Roeb
authors: Reinhart
authors: R
authors: Zachoval
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D000071451:Chitinase-3-Like Protein 1; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D007797:Laminin / Q000097:blood; D037102:Lectins / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D012372:ROC Curve; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000097:blood
chemical_list: D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D007797:Laminin; D037102:Lectins; D010446:Peptide Fragments; D011347:Procollagen; D019715:Tissue Inhibitor of Metalloproteinase-1; C042813:procollagen type I carboxy terminal peptide; D019716:Tissue Inhibitor of Metalloproteinase-2; D006820:Hyaluronic Acid; D020780:Matrix Metalloproteinase 9