Background/Aims
Liver biopsy has been used to evaluate the degree of hepatic fibrosis in patients with chronic liver diseases. It is important to assess liver fibrosis when following the course of chronic liver diseases. Histopathological examination of percutaneous biopsy specimens is invasive and is also of questionable value because of the heterogenous distribution of pathological changes in the liver. Therefore, non-invasive methods to determine the progress of liver fibrosis are needed. Serum hyaluronic acid and type IV collagen are known to be related to hepatic fibrosis. This study was performed to evaluate the clinical usefulness of serum hyaluronic acid and type IV collagen measurement as a differential point in patients with chronic liver diseases and early cirrhosis. Methods: This study included 109 patients with chronic liver diseases caused by various etiologies. Liver biopsy and histopathological classification were done in all patients. Serum hyaluronic acid and type IV collagen were measured by one-step sandwich binding protein assay and one-step sandwich enzyme immunoassay. Results: The concentrations of hyaluronic acid and type IV collagen in the early cirrhosis group (208.5±186.4 ng/mL, 242.1±162.8 ng/mL) were significantly higher (p<0.01) than those in the normal and fatty liver group (26.3±21.7 ng/mL, 79.2±28.8 ng/mL), mild chronic hepatitis group (22.8±15.4 ng/mL, 125.5±79.7 ng/mL), moderate to severe hepatitis group (66.3±60.5 ng/mL, 148.5±78.7 ng/mL). At the cutoff value of 100 ng/mL for hyaluronic acid and 200 ng/mL for type IV collagen, the sensitivities were 66.7% and 55.6%, and specifities were 82.9% and 89%, and diagnostic efficiencies were 78.9% and 80.7% respectively for discriminating patients with cirrhosis (4 points) from the mild to severe fibrosis (0∼3 points). Conclusions: The serum levels of hyaluronic acid and type IV collagen may be sensitive markers of fibrotic process in chronic liver diseases and useful biochemical markers in differentiation of the patients with early cirrhosis from those with chronic liver diseases.(Korean J Hepatol 1999;5:190－199)
