Combined serum biomarkers in non-invasive diagnosis of non-alcoholic steatohepatitis——Combined biomarkers in NASH non-invasive diagnosis
作者单位：Department of Pathology and HepatologyBeijing 302 Hospital Institute of Infectious Diseases/Liver Failure Medical CenterBeijing 302 Hospital Center for Clinical TrialBeijing 302 Hospital Center for Clinical LaboratoryBeijing 302 Hospital
会议名称：《第十四届中国体视学与图像分析学术会议》
会议日期：2015年
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
基 金：Clnical High-tech Key Project(2010 jxgs099) Research Fund of Capitanl Medical Development(20142-5032) Chinese Foundation for Hepatitis Prevention and Control-WBE Liver Fibrosis Foundation(CFHPC 20131020)
关 键 词：Non-alcoholic steatohepatitis Non-invasive diagnosis Combined serum biomarker Accuracy
摘 要：Background Non-alcoholic steatoheaptitis(NASH),the critical stage of non-alcoholic fatty liver disease(NAFLD),is of chronic progression and can develop cirrhosis even hepatocellular carcinoma(HCC).However,non-invasive biomarkers for NASH diagnosis remain poorly applied in clinical *** study aims at testing the accuracy of the combination of cytokeratin-18 M30 fragment(CK-18-M30),fibroblast growth factor 21(FGF-21),interleukin 1 receptor antagonist(IL-1 Ra),pigment epithelium-derived factor(PEDF)and osteoprotegerin(OPG)in diagnosing NAFLD and *** 179 patients with biopsy-proven NAFLD were enrolled as training group,91 ageand gender-matched healthy subjects were recruited at the same time as controls.63 otherNAFLD patients were separately collected as validation group.45 alcoholic fatty liver disease(AFLD)patients,50hepatitis B virus(HBV)patients,52 hepatitis C virus(HCV)patients were also *** biomarker levels were measured by enzyme-linked immunosorbent *** Serum levels of CK-18-M30,FGF-21,IL-1Ra and PEDF increased,while OPG decreased in a stepwise fashion in controls,non-NASH NAFLD patients and NASH patients(P0.01).The area under receiver-operating characteristics curve to diagnose NASH was 0.86 for CK-18-M30,O.89 for},0.89 for IL-1Ra,0.89 for PEDF and 0.89 for ***-18-M30 had 70%negative predictive value(NPV)and 79%positive predictive value(PPV)to diagnose NASH.A 5-step approach measuring CK-18-M30 followed by FGF21,IL-1Ra,PEDF and OPG gradually improved the NPV to 76%and PPV to 85%,which reached80%and 76%respectively in the validation *** Compared to single biomarker,stepwise combination of CK-18-M30,FGF-21,IL-1 Ra,PEDF and OPG can further improve the accuracy in diagnosing NASH.