الفهرس | Only 14 pages are availabe for public view |
Abstract The present study included 60 male cases aged 27 to 45 years (mean age 37.9 ± 6.04 years) with already diagnosed chronic HCV infection (group I). 20 healthy males, age matched with the patients group were studied as a control group (group II). All patients were collected from Ain Shams university hospitals from July 2006 to December 2008. Both groups were subjected to full clinical history, clinical examination, Routine laboratory assessment (liver function tests, kidney function tests and complete blood picture), ultrasound evaluation, liver biopsy (group I), assessment of HA level (All serum samples were obtained in the day of liver biopsy), assessment of serum PIIINP. Exclusion criteria: Any patient with kidney disease, joint injury, alcohol intake was excluded from the study. Significant relationships are found between median values of HA in group I and II, and also between median values PIIINP in group I and II. A significant relationship exists between HA median values and different stages of fibrosis, and also between PIIINP median value and different stages of fibrosis in group I. The higher the stage of fibrosis, the more increase in median values of both HA and PIIINP. A significant relationship exists between HA median values and different degrees of activity, and also between PIIINP median value and different degrees of activity in group I. The higher the degree of activity, the more increase in median values of both HA and PIIINP. A strong positive highly significant correlation is found between HA and PIIINP among studied patients. The more increase in HA values the more increase in PIIINP. Summary 128 Hyaluronic acid is more accurate than PIIINP in diagnosis of different grades of fibrosis [significant fibrosis (F2-F4), severe fibrosis (F3-F4) and cirrhosis (F4)] with AUCs of 0.965, 0.940 and 0.927, respectively, for HA, in comparison to AUCs of 0.935, 0.843, 0.778, respectively, for PIIINP. Two cut-off values of HA were chosen for identifying absence and presence of different grades of fibrosis [significant fibrosis (F2-F4), severe fibrosis (F3-F4) and cirrhosis (F4)]. Significant fibrosis can be predicted by a HA level of < 55 ng/mL for its absence (NPV of 90%) and of > 83 ng/mL for its presence (PPV of 100%). Severe fibrosis can be predicted by a HA level of ≤ 74 ng/mL for its absence (NPV of 100%) and of > 135 ng/mL for its presence (PPV of 89%). Cirrhosis can be predicted by an HA level of ≤ 110 ng/mL for its absence (NPV of 100%) and of > 220 ng/mL for its presence (PPV of 80%). Two cut-off values of PIIINP were chosen for identifying absence and presence of different grades of fibrosis [significant fibrosis (F2-F4), severe fibrosis (F3-F4) and cirrhosis (F4)]. Significant fibrosis can be predicted by a PIIINP level of < 4.7 ug/L for its absence (NPV of 90%) and of > 6.32 ug/L for its presence (PPV of 100%). Severe fibrosis can be predicted by a PIIINP level of ≤ 5.85 ug/L for its absence (NPV of 92%) and of > 6.62 ug/L for its presence (PPV of 78%). Cirrhosis can be predicted by an PIIINP level of ≤ 6.06 ug/L for its absence (NPV of 92%) and of > 6.95 ug/L for its presence (PPV of 43%). |