Serum markers for predicting significant necroinflammatory activity in patients with chronic hepatitis B

Abstract

OBJECTIVES: The aim of this study was to determine the serum markers that predict significant inflammation in patients with chronic hepatitis B (CHB). DESIGN AND METHODS: Between October 2005 and June 2009, 384 subjects with CHB were enrolled. RESULTS: Multiple logistic regression analysis identified the ALT, hyaluronic acid (HA) and procollagen III N-terminal peptide (PIIINP) as independent predictors of significant inflammation (grade≥3). We constructed a formula for predicting significant inflammation. A significant inflammation (SI) score = 1.773 × ALT score + 1.599 × PIIINP score + 0.677 × HA score 1.962. The area under receiver operating characteristic curve of the SI score was 0.831. The sensitivity, specificity, positive predictive value and negative predictive value of the SI score were 79.5%, 70.8%, 76.8% and 74.3%, respectively. CONCLUSIONS: A simple scoring system including ALT, PIIINP and HA is an accurate non-invasive predictor of significant inflammatory activities in patients with CHB.

목적: 이 연구의 목적은 만성 B형간염 환자에서 중등도 이상의 염증 괴사 활동도를 예측하는 혈청 마커를 개발하는 것이다. 방법: 간 조직 검사를 시행한 만성 B형 간염 환자 총 384명의 환자가 연구에 포함 되었다. 결과: 혈청 ALT 및 Hyaluronic acid(HA), procollagen III N-terminal peptide(PIIINP)가 Batts-Lugwig inflammatory activity grade 3 이상의 염증 정도를 예측하는 독립 인자였으며, 이 항목들을 이용하여 중등도 이상의 염증괴사 활동도를 예측하기 위한 식을 개발하였다. Significant inflammation (SI) score = 1.773 × ALT score + 1.599 × PIIINP score + 0.677 × HA score  1.962. SI score의 ROC 곡선 아래 역역은 0.831 이었고, 민감도 및 특이도, 양성 예측도, 음성 예측도는 각각 79.5%, 70.8%, 76.8%, 74.3% 였다. 결론: 만성 B형 간염 환자에서 ALT, hyaluronic acid (HA) and procollagen III N-terminal peptide (PIIINP)를 이용하여 비침습적이고 정확한 염증 모델을 개발하였다.