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[Correlation of serum markers with fibrosis staging in chronic viral hepatitis].

OBJECTIVE
To assess the correlation between serological fibrosis markers and staging of fibrosis in chronic hepatitis.


METHODS
One hundred and fourteen (114) biopsy and 13 autopay liver specimen were reviewed pathohistologically. Serum samples for liver function tests and fibrosis marker assays including serum P-III-P, IV collagen, laminin (LN), hyaluronic acid (HA), h-TIMP-1 were collected simultaneously right before the biopsy or autopsy. HE, sirius red stains as well as staining for reticulum and elastic fiber were done. In besides, IV collagen, laminin, activated stellate cell were assayed by immunohistochemical methods.


RESULTS
Among 127 patients, 92 cases of chronic viral hepatitis including early cirrhosis and 18 cases of hepatic cirrhosis were examined pathologically (17 alcoholic liver disease excluded). The overall inflammatory index and fibrotic scoring were noticed to be significantly correlated with each other (r = 0.82, p < 0.01); The markers, such as HA, P-III-P, LN, IV collagen, h-TIMP-1 were positively correlated with the fibrotic staging and scoring (r = 0.610, 0.575, 0.607, 0.641, 0.606 respectively). The higher the marker level, the more serious the fibrotic change. In addition, (18 cases) patients with active cirrhosis (16 cases) showed higher serum marker level than that of the early cirrhosis and the serum markers in the later were higher than that in the non-active cirrhosis.


CONCLUSION
Serum fibrosis markers are fairly well correlated with the staging of fibrosis and are considered to be the valuable references for clinical diagnosis. The close correlation between inflammation process and fibrosis suggests that the inflammatory process plays an important role in fibrogenesis.