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2015 ; 10
(9
): e0137302
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Markers of Collagen Remodeling Detect Clinically Significant Fibrosis in Chronic
Hepatitis C Patients
#MMPMID26406331
Nielsen MJ
; Kazankov K
; Leeming DJ
; Karsdal MA
; Krag A
; Barrera F
; McLeod D
; George J
; Grønbæk H
PLoS One
2015[]; 10
(9
): e0137302
PMID26406331
show ga
BACKGROUND AND AIM: Detection of advanced fibrosis (Metavir F?3) is important to
identify patients with a high urgency of antiviral treatments vs. those whose
treatment could be deferred (F?2). The aim was to assess the diagnostic value of
novel serological extracellular matrix protein fragments as potential biomarkers
for clinically significant and advanced fibrosis. METHODS: Specific protein
fragments of matrix metalloprotease degraded type I, III, IV and VI collagen
(C1M, C3M, C4M, C6M) and type III and IV collagen formation (Pro-C3 and P4NP7S)
were assessed in plasma from 403 chronic hepatitis C patients by specific ELISAs.
Patients were stratified according to Metavir Fibrosis stage; F0 (n = 46), F1 (n
= 161), F2 (n = 95), F3 (n = 44) and F4 (n = 33) based on liver biopsy. RESULTS:
Pro-C3 was significantly elevated in patients with significant fibrosis (?F2)
compared to F0-F1 (p<0.05), while the markers C3M, C4M, C6M and P4NP7S were
significantly elevated in patients with advanced fibrosis (?F3) compared to F0-F2
(p<0.05). C1M showed no difference between fibrosis stages. Using Receiver
Operating Characteristics analysis, the best marker for detecting ?F2 and ?F3 was
Pro-C3 with AUC = 0.75 and AUC = 0.86. Combination of Pro-C3 and C4M with age,
BMI and gender in a multiple ordered logistic regression model improved the
diagnostic value for detecting ?F2 and ?F3 with AUC = 0.80 and AUC = 0.88.
CONCLUSION: The Pro-C3 protein fragment provided clinically relevant diagnostic
accuracy as a single marker of liver fibrosis. A model combining Pro-C3 and C4M
along with patient's age, body mass index and gender increased the diagnostic
power for identifying clinically significant fibrosis.
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