Measurements of serum procollagen-III peptide and M30 do not improve the diagnostic accuracy of transient elastography for the detection of hepatic fibrosis in patients with nonalcoholic fatty liver disease.
BACKGROUND
Transient elastography (TE) has recently emerged as an accurate noninvasive imaging method for the diagnosis of liver fibrosis in nonalcoholic fatty liver disease (NAFLD). Here, we tested whether adding serum measures of serum procollagen-III peptide (PIIIP) and caspase-cleaved cytokeratin 18 fragment (M30) to TE could improve its diagnostic accuracy in patients with biopsy-proven NAFLD.


METHODS
TE was performed in 87 patients with NAFLD. Serum PIIIP and M30 levels were determined by enzyme-linked immunosorbent assay. Liver histology was considered the gold standard. The diagnostic accuracies were assessed by measuring the area under the receiver operating curve.


RESULTS
At histopathological examination, 34 patients (39.1%) had significant fibrosis (F2-F4) and 19 patients (21.8%) had advanced fibrosis (F3-F4). Both TE and serum M30 levels were independent predictors of fibrosis, whereas no association was found with PIIIP. No significant differences in terms of sensitivity and specificity for both significant and advanced fibrosis were evident for TE, serum M30, or their combination. Moreover, the area under the receiver operating curves of serum M30 combined with TE did not differ significantly from those of either test alone.


CONCLUSIONS
Both TE and serum M30 levels are accurate for the noninvasive diagnosis of fibrosis in NAFLD. However, their combination did not improve the overall diagnostic accuracy.
Departments of aRadiology bGastroenterology, School of Medicine cLiver Research Unit, Institute of Gastroenterology, Marmara University dDepartment of Gastroenterology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
Rabia
R
Ergelen
Umit
U
Akyuz
Yucel
Y
Aydin
Fatih
F
Eren
Yusuf
Y
Yilmaz
D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D053538:Keratin-18 / Q000097:blood*; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications; D010446:Peptide Fragments / Q000097:blood*; D011347:Procollagen / Q000097:blood*; D012372:ROC Curve; D055815:Young Adult
D015415:Biomarkers; D053538:Keratin-18; C561463:M30 cytokeratin-18 peptide, human; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide