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Rosso C, Caviglia GP, Abate ML, Vanni E, Mezzabotta L, Touscoz GA, Olivero A, Marengo A, Rizzetto M, Bugianesi E, Smedile A. Cytokeratin 18-Aspartate396 apoptotic fragment for fibrosis detection in patients with non-alcoholic fatty liver disease and chronic viral hepatitis. Dig Liver Dis 2016; 48:55-61. [PMID: 26514735 DOI: 10.1016/j.dld.2015.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 09/08/2015] [Accepted: 09/19/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND The combination of non-invasive markers for the detection of fibrosis in patients with chronic liver diseases is still a matter of debate. AIMS To test the performance of cytokeratin18-Aspartate396 alone or in combination with transient elastography as a marker of fibrosis, compared to liver biopsy as gold standard. METHODS In 259 prospectively enrolled patients with chronic liver diseases, clinical, biochemical, and histological features were assessed. Serum cytokeratin18-Aspartate396 and Fibroscan were performed within 6 months prior to liver biopsy. RESULTS Cytokeratin18-Aspartate396 levels predicted both significant and advanced fibrosis in non-alcoholic fatty liver disease group, correctly identifying 83.7% and 80.8% of cases, respectively. Liver stiffness performed best in predicting severe fibrosis in patients with chronic viral infection, correctly identifying 78.7% of chronic hepatitis B and 88.6% of chronic hepatitis C subjects. The combination of cytokeratin18-Aspartate396 and liver stiffness improved their diagnostic performance for the detection of significant and advanced fibrosis in non-alcoholic fatty liver disease group, only (sensitivity=78.3%, specificity=90.7%; sensitivity=91.7%, specificity=71.6%, respectively). CONCLUSION Cytokeratin18-Aspartate396 and liver stiffness can improve the non-invasive prediction of significant and advanced fibrosis in patients with non-alcoholic fatty liver disease, while in hepatitis B and C virus infected patients their combined use had no advantage over the diagnostic accuracy of transient elastography alone.
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Affiliation(s)
- Chiara Rosso
- Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy.
| | - Gian Paolo Caviglia
- Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Maria Lorena Abate
- Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Ester Vanni
- Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy; Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Lavinia Mezzabotta
- Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy; Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Giovanni Antonio Touscoz
- Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Antonella Olivero
- Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Andrea Marengo
- Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy; Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Mario Rizzetto
- Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy; Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Elisabetta Bugianesi
- Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy; Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Antonina Smedile
- Liver Physiopathology Lab, Department of Medical Sciences, University of Turin, Turin, Italy; Division of Gastroenterology and Hepatology, Città della Salute e della Scienza University Hospital, Turin, Italy
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