Helicobacter pylori and its Associated Diseases

AIM: Noninvasive methods for assessment and follow-up ofhepatic fibrosis are important for the management of patients withchronic liver disease. Our aim was to assess a new panel of surrogatebiomarkers for prediction of severe hepatic fibrosis in patients withchronic liver disease of different aetiology.METHODS: 118 patients [62 males (52.5%) and 56 females](47.5%) were prospectively enrolled with a mean age of 55.6 years±14.9. The aetiology of chronic liver disease was hepatitis B virusinfection (n=12), hepatitis C virus infection (n=20), autoimmunehepatitis (n=36), alcoholic steatohepatitis (n=10), non-alcoholicsteatohepatitis: (n=12), hepatocellular carcinoma (n=16). 12 patientshad no evidence of liver disease. Biomarkers of hepatic fibrosis andliver function tests (α2-macroglobulin, haptoglobin, apolipoproteinA1, total bilirubin, GGT, ALT, total cholesterol, AST, albumin,CA19-9, CA125, CA 15-3, INR, platelet count, hyaluronic acid, nitricoxide) were analyzed in serum. As reference for staging of fibrosiswe used FibroTest and FibroScan. Biomarkers were correlated tohepatic fibrosis by univariate and multivariate analyses as well aslogistic regression.RESULTS: Univariate and multivariate analysis indicated thatplatelet count, α2-macroglobulin, total bilirubin, GGT and totalcholesterol were the most relevant biomarkers related to the stage ofhepatic fibrosis. A new panel for prediction of severe hepatic fibrosiswas created using these relevant parameters. Applying this panel;severe hepatic fibrosis was predicted with a sensitivity of 97.4%and a specificity of 85.9% in comparison with FibroTest. Also asensitivity of 78.8% and specificity of 90.9% was obtained by thepanel in comparison to FibroScan.CONCLUSION: The new noninvasive panel allows accurateprediction of severe liver fibrosis in different types of chronic liverdisease.