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Hepatocyte apoptosis fragment product cytokeratin-18 M30 level and non-alcoholic steatohepatitis risk diagnosis:an international registry study

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Chinese Medical Journal 2023年第3期136卷 341-350页

作者： Huai Zhang Rafael S.Rios Jerome Boursier Rodolphe Anty Wah-Kheong Chan Jacob George Yusuf Yilmaz Vincent Wai-Sun Wong Jiangao Fan Jean-Francois Dufour George Papatheodoridis Li Chen Jorn M.Schattenberg Junping Shi Liang Xu Grace Lai-Hung Wong Naomi F.Lange Margarita Papatheodoridi Yuqiang Mi Yujie Zhou Christopher D.Byrne Giovanni Targher Gong Feng Minghua Zheng department of Biostatistics and Medical Record The First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiang 325000China department of Hepatology MAFLD Research CenterThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiang 325000China Service d’Hépato-Gastroentérologie et Oncologie Digestive Centre Hospitalier Universitaire d’AngersAngersFrance laboratoire HIFIH UPRES EA3859SFR ICAT 4208Universitéd’AngersAngersFrance Université Cote d’Azur CHUINSERMU1065C3M06204 NiceFrance Gastroenterology and Hepatology Unit Department of MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia Storr Liver Centre Westmead Institute for Medical ResearchWestmead Hospital and University of SydneySydneyNSWAustralia department of Gastroenterology School of MedicineMarmara UniversityIstanbulTurkey department of Gastroenterology School of MedicineRecep Tayyip Erdogan UniversityRizeTurkey department of Medicine and Therapeutics The Chinese University of Hong KongHong Kong 999077China department of Gastroenterology Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghai 200000China University Clinic for Visceral Surgery and Medicine InselspitalUniversity Hospital BernBernSwitzerland Graduate School for Health Sciences University of BernBernSwitzerland Academic department of Gastroenterology Medical School of National and Kapodistrian University of AthensGeneral Hospitalof Athens“Laiko”AthensGreece department of Gastroenterology Ruijin HospitalShanghai 200000China Metabolic Liver Research Program I Department of MedicineUniversity Medical Center MainzMainzGermany The Affiliated Hospital of Hangzhou Normal University HangzhouZhejiang 310000China Tianjin Second People’s Hospital Tianjin 300000China Division of Gastroenterology and Hepatology Key Laboratory of Gastroenterology and HepatologyMinistry of HealthRenji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai Institute of Digestive DiseaseShanghai 200000Ch

Background:Liver biopsy for the diagnosis of non-alcoholic steatohepatitis(NASH)is limited by its inherent invasiveness and possible sampling *** studies have shown that cytokeratin-18(CK-18)concentrations may be useful in diagnosing NASH,but results across studies have been *** aimed to identify the utility of CK-18 M30 concentrations as an alternative to liver biopsy for non-invasive identification of ***:Individual data were collected from 14 registry centers on patients with biopsy-proven non-alcoholic fatty liver disease(NAFLD),and in all patients,circulating CK-18 M30 levels were *** with a NAFLD activity score(NAS)≥5 with a score of≥1 for each of steatosis,ballooning,and lobular inflammation were diagnosed as having definite NASH;individuals with a NAS≤2 and no fibrosis were diagnosed as having non-alcoholic fatty liver(NAFL).Results:A total of 2571 participants were screened,and 1008(153 with NAFL and 855 with NASH)were finally *** CK-18 M30 levels were higher in patients with NASH than in those with NAFL(mean difference 177 U/L;standardized mean difference[SMD]:0.87[0.69–1.04]).There was an interaction between CK-18 M30 levels and serum alanine aminotransferase,body mass index(BMI),and hypertension(Pder the receiver operating characteristics(AUROC)for NASH was 0.750(95%confidence intervals:0.714–0.787),and CK-18 M30 at Youden’s index maximum was 275.7 U/*** sensitivity(55%[52%–59%])and positive predictive value(59%)were not ***:This large multicenter registry study shows that CK-18 M30 measurement in isolation is of limited value for non-invasively diagnosing NASH.

关键词： Apoptosis Diagnosis Cytokeratin-18 Liver histology Non-alcoholic steatohepatitis Non-alcoholic fatty liver disease

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