title: COMP serum levels: A new non-invasive biomarker of liver fibrosis in patients with chronic viral hepatitis.
abstract: OBJECTIVE
  Recently we have shown that cartilage oligomeric matrix protein (COMP), a fibrillar collagen assembly regulator, is strongly associated with cirrhosis and hepatocellular carcinoma progression. Therefore, we assessed whether serum COMP levels can be used as a non-invasive fibrosis marker in patients with chronic viral hepatitis (CVH) and compared this marker with standard methods for disease stage assessment [histology, transient elastography (TE), APRI, FIB-4].
  
  
  METHODS
  Sera from 116 CVH patients, 66 HBV [24 female; median age 53(22-76)] and 50 HCV [21 female; median age 48.5(25-69)] were investigated by COMP-ELISA. APRI and FIB-4 score was calculated in all along with TE. Liver biopsy was performed in 61. Patients were divided into two groups (F1/F2 and F3/F4) according to Metavir score.
  
  
  RESULTS
  55/116 (47%) CVH patients were classified in F3/F4-group according to TE [14.3(9.3-75)kPa]. APRI score was >1.5 in 21/116 and FIB-4>3.25 in 20/116. Liver histology revealed 24/61 (39%) patients with significant fibrosis (stage 3-4), while 12/61 (19.7%) had cirrhosis. COMP levels correlated with TE measurements (r=0.5; p<0.001) and APRI score (r=0.23; p<0.02). The diagnostic accuracy of COMP in detecting cirrhosis was as good as TE, APRI and FIB-4 index (AUC 0.884) with sensitivity and specificity of 83.3% and 83.7% (cut-off 11.5U/L).
  
  
  CONCLUSIONS
  COMP serum levels performed as well as TE, APRI and FIB4 score in detecting cirrhosis in CVH patients, suggesting COMP as a sensitive non-invasive, easy to perform biomarker of liver fibrosis. Further studies are needed in order to validate our findings in CVH patients.
authors.affiliation: Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, Thessaly University, Larissa, Greece.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Zachou
authors.affiliation: Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, Thessaly University, Larissa, Greece.
authors.forename: Stella
authors.initials: S
authors.lastname: Gabeta
authors.affiliation: Inova Diagnostics, Inc., San Diego, CA, United States.
authors.forename: Zakera
authors.initials: Z
authors.lastname: Shums
authors.affiliation: Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, Thessaly University, Larissa, Greece.
authors.forename: Nikolaos K
authors.initials: NK
authors.lastname: Gatselis
authors.affiliation: Department of Pathology, School of Medicine, University of Thessaly, Larissa, Greece.
authors.forename: George K
authors.initials: GK
authors.lastname: Koukoulis
authors.affiliation: Inova Diagnostics, Inc., San Diego, CA, United States.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Norman
authors.affiliation: Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, Thessaly University, Larissa, Greece. Electronic address: georgedalekos@gmail.com.
authors.forename: George N
authors.initials: GN
authors.lastname: Dalekos
mesh_terms: D000328:Adult; D000368:Aged; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D064236:Cartilage Oligomeric Matrix Protein / Q000097:blood*; D016022:Case-Control Studies; D018450:Disease Progression; D054459:Elasticity Imaging Techniques; D005260:Female; D006115:Greece; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D064236:Cartilage Oligomeric Matrix Protein; D001219:Aspartate Aminotransferases
keywords: APRI; Cartilage oligomeric matrix protein; Cirrhosis; Hepatitis B; Hepatitis C; Liver fibrosis