title: Clinical Benefits of Biochemical Markers of Fibrosis in Egyptian Children With Chronic Liver Diseases.
abstract: BACKGROUND
  The need for repetition of liver biopsy, especially in assessing the degree of fibrosis and follow-up of treatment protocols, justifies an intensive search for non-invasive alternatives. We attempted to investigate the clinical usefulness of serum fibrogenesis markers in pediatric chronic liver diseases.
  
  
  METHODS
  We measured serum levels of TGF-β1, collagen IV, laminin, MMP-2 and EGF-R, in 50 children with chronic liver disease (HBV, HCV and Bilharziasis) and 30 healthy controls, and determined their relationship to frequently used liver function tests and liver biopsy findings in patients.
  
  
  RESULTS
  TGF-β1, collagen IV, laminin and MMP-2, but not EGF-R, were significantly higher in patients than in controls (P < 0.01). None of these markers correlated with the histological fibrosis stage, whereas laminin correlated with necroinflammatory activity (P < 0.01). TGF-β1, collagen IV, laminin and MMP-2 had the ability to discriminate patients with significant fibrosis, while only collagen IV and laminin were able to discriminate those with cirrhosis. Among these markers, collagen IV had the best predictive accuracy for significant fibrosis (AUROC 0.94; PPV 91.5%) and cirrhosis (AUROC 0.85; PPV 80%).
  
  
  CONCLUSIONS
  In conclusion, these markers may be useful in reducing but not replacing the need for liver biopsy in the monitoring of disease progression and treatment effectiveness and might be an inseparable part of assessment of chronic hepatopathies.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Tawhida Y
authors.initials: TY
authors.lastname: Abdel-Ghaffar
authors.affiliation: Department of Pediatric Hepatology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt.
authors.forename: Behairy E
authors.initials: BE
authors.lastname: Behairy
authors.affiliation: Department of Child Health, National Research Centre, El Bohouth Street, Dokki 12311, Cairo, Egypt.
authors.forename: Azza Abd
authors.initials: AA
authors.lastname: El-Shaheed
authors.affiliation: Medical Biochemistry Department, National Research Centre, El Bohouth Street, Dokki 12311, Cairo, Egypt.
authors.forename: Karam
authors.initials: K
authors.lastname: Mahdy
authors.affiliation: Department of Pathology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Batanony
authors.affiliation: Department of Pediatric Hepatology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt.
authors.forename: Mohsen H
authors.initials: MH
authors.lastname: Hussein
authors.affiliation: Department of Pediatric Hepatology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt.
authors.forename: Mostafa M
authors.initials: MM
authors.lastname: Sira
keywords: Bilharziasis; Collagen IV; Egyptian children; Hepatitis B virus; Hepatitis C virus; Liver fibrosis