血清YKL-40作为慢性乙型肝炎患者肝纤维化的生物标志物，ALT

StephenW

Infection. 2018 Mar 29. doi: 10.1007/s15010-018-1136-2. [Epub ahead of print]
Serum YKL-40 as a biomarker for liver fibrosis in chronic hepatitis B patients with normal and mildly elevated ALT.
Yan L1, Deng Y1,2, Zhou J1, Zhao H1, Wang G3,4,5; China HepB-Related Fibrosis Assessment Research Group.
Collaborators (9)

Zhang DZ, Xie SB, Zhang XQ, Xie Q, Cheng J, Liang W, Meng F, Bai L, Li J.
Author information

1
    Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing, 100034, China.
2
    The Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
3
    Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing, 100034, China. [email protected].
4
    The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang, China. [email protected].
5
    Peking University International Hospital, Beijing, China. [email protected].

Abstract
PURPOSE:

YKL-40 is a chitinase-like protein expressed in multiple tissues including liver and is reported as a fibrosis marker. This study aimed to determine whether YKL-40 could serve as a diagnostic marker for the assessment of liver fibrosis in chronic hepatitis B patients with normal and mildly elevated ALT.
METHODS:

Six hundred and eighty-five patients with chronic hepatitis B infection were enrolled in this study from October 2013 to March 2016. All patients underwent liver biopsy and then staged based on Ishak histological system. Serum YKL-40 levels were measured by Human Magnetic Luminex Assays.
RESULTS:

Among chronic hepatitis B patients with normal and mildly elevated ALT, almost more than 30% of patients have significant liver fibrosis. Serum YKL-40 levels increased significantly in parallel with the progression of fibrosis in patients with ALT less than two times the upper limit of normal range (P < 0.0001). Multivariate analysis revealed that serum YKL-40, hyaluronic acid, PLT, and AST were independently associated with significant fibrosis. We established a novel YKL-40-based fibrosis model for patients with ALT less than two times the upper limit of normal range (ULN). YKL-40 model was superior to APRI, FIB-4, Forns' index, and Hui model for diagnosis of significant fibrosis in patients with ALT < 2ULN, with AUROCs of 0.786 [95% confidence interval (CI) 0.726-0.846] in the training group, 0.831 (95%CI 0.752-0.910) in the validation group and 0.801 (95%CI 0.753-0.849) in the entire cohort.
CONCLUSION:

Serum YKL-40 is a feasible biomarker of liver fibrosis in chronic hepatitis B patients. YKL-40 model was superior to APRI, FIB-4, Forns' index and Hui model for diagnosis of significant fibrosis in patients with normal and mildly elevated ALT.
KEYWORDS:

Chronic hepatitis B; Liver fibrosis; YKL-40

PMID:
    29600444
DOI:
    10.1007/s15010-018-1136-2

StephenW

感染。 2018年3月29日doi：10.1007 / s15010-018-1136-2。 [电子版提前打印]
血清YKL-40作为慢性乙型肝炎患者肝纤维化的生物标志物，ALT正常和轻度升高。
阎立1，邓1 1,2，周1 1，赵海1，王3 3,4,5;中国HepB相关纤维化评估研究组。
合作者（9）

张大Z，谢SB，张晓，，谢，，程江，梁伟，孟飞，白莉，李杰
作者信息

1
    北京市西城区西四库街8号北京大学第一医院肝病中心传染病科100034
2
    西南医科大学附属医院皮肤科，四川泸州646000
3
    北京市西城区西四库街8号北京大学第一医院肝病中心传染病科100034 [email protected]。
4
    浙江大学传染病诊疗中心协同创新中心，浙江杭州。 [email protected]。
五
    北京大学国际医院，北京，中国。 [email protected]。

抽象
目的：

YKL-40是在包括肝脏在内的多种组织中表达的几丁质酶样蛋白，并被报道为纤维化标记。本研究旨在确定YKL-40是否可作为评估ALT正常和轻度升高的慢性乙型肝炎患者肝纤维化的诊断指标。
方法：

从2013年10月至2016年3月，共有685例慢性乙型肝炎感染患者参加了本研究。所有患者均行肝活检，然后根据Ishak组织学系统进行分期。通过Human Magnetic Luminex Assays测量血清YKL-40水平。
结果：

在ALT正常和轻度升高的慢性乙肝患者中，几乎超过30％的患者具有显着的肝纤维化。 ALT水平低于正常范围上限两倍的患者（P <0.0001），血清YKL-40水平显着增加，并伴有纤维化进展。多变量分析显示血清YKL-40，透明质酸，PLT和AST与显着的纤维化独立相关。我们为ALT低于正常范围上限（ULN）两倍的患者建立了一种基于YKL-40的新型纤维化模型。 YKL-40模型在ALT <2ULN患者中优于APRI，FIB-4，Forns'指数和Hui模型以诊断明显纤维化，AUROCs为0.786 [95％置信区间（CI）0.726-0.846]训练组，验证组为0.831（95％CI为0.752-0.910），整个队列为0.801（95％CI为0.753-0.849）。
结论：

血清YKL-40是慢性乙型肝炎患者肝纤维化的可行生物标志物。 YKL-40模型优于APRI，FIB-4，Forns'指数和Hui模型，用于诊断ALT正常和轻度升高的重度纤维化患者。
关键词：

慢性乙型肝炎;肝纤维化; YKL-40

结论：
    29600444
DOI：
    10.1007 / s15010-018-1136-2

Hepbest

血清YKL-40是慢性乙型肝炎患者肝纤维化的可行生物标志物。 YKL-40模型优于APRI，FIB-4，Forns'指数和Hui模型，用于诊断ALT正常和轻度升高的重度纤维化患者。

那可以申请临床啊