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Combined serum biomarkers in non-invasive diagnosis of non-alcoholic steatohepatitis——Combined biomarkers in NASH non-invasive diagnosis

Combined serum biomarkers in non-invasive diagnosis of non-a...

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第十四届中国体视学与图像分析学术会议

作者： Yang Mei Xu Dongping Liu Yuan Guo Xiaodong Li Wenshu Guo Chaonan Zhang Hongping Gao Yinjie Mao Yuanli Zhao Jingmin Department of Pathology and Hepatology Beijing 302 Hospital Institute of Infectious Diseases/Liver Failure Medical Center Beijing 302 Hospital Center for Clinical Trial Beijing 302 Hospital Center for Clinical Laboratory Beijing 302 Hospital

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(P<0.01).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.

关键词： Non-alcoholic steatohepatitis Non-invasive diagnosis Combined serum biomarker Accuracy

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