Comparison of Serum Hyaluronate and PIINP Levels with Liver Histology in Chronic Liver Disease Type C

Kim, Kyung Ah; Woo, Gwang Hoon; Lim, Young Suk; Kim, Tae Hun; Lee, Jun Sung; Yoon, Jung Hwan; Jang, Ja Jun; Kim, Chung Yong; Lee, Hyo Suk

Abstract

BACKGROUND/AIMS: In chronic liver disease type C, there have been no clinically useful serum markers to reflect histological findings such as hepatic necroinflammation and fibrosis except for an invasive liver biopsy. In an attempt to find out serum markers predicting these histological degree of progression in patients with chronic liver disease type C, we compared the histological findings with the levels of serum hyaluronate and N-terminal peptide of procollagen III (PIIINP) which are produced during the metabolism of extracellular matrices.
METHODS
Thirty-seven patients with antibody to HCV were enrolled in this study. Histological findings were scored for degree of piecemeal necrosis, lobular inflammation and fibrosis according to Ludwig's score. Then, serum concentrations of hyaluronate and PIIINP were measured by enzyme immunoassay and radioimmunoassay, respectively.
RESULTS
Hyaluronate at the concentration of 100 ng/mL had a positive predictive value of 80% and a negative predictive value of 100% for diagnosis of stage 3, 4 fibrosis. The positive and negative predictive values of PIIINP at the level above 1.5 U/mL were 100% and 89.3% for the diagnosis of grade 3, 4 piecemeal necrosis, and 100%, 85.7% for the diagnosis of grade 3, 4 lobular inflammation, respectively.
CONCLUSIONS
Serum hyaluronate may be a useful serum marker of liver fibrosis compared with PIIINP. However, PIIINP may be a useful marker for detecting grade 3, 4 necroinflammation in patients with chronic liver disease type C.