만성 B 형 바이러스성 간질환에서 혈청 히알루론산치와 4형 콜라겐치의 임상적 의의 = The Clinical Significance of Serum Hyaluronic Acid and Type 4 Collagen Levels in Chronic Viral Hepatitis and Liver Cirrhosis

다국어 초록 (Multilingual Abstract)

Objective: Histopathologic evaluation has been used to evaluate the degree of hepatic fibrosis. This method may have limitations because percutaneous liver biopsy is invasive and histopathologic change shows heterogenicity in the liver. It has been reported that the biochemical markers may have an important role in evaluating the degree of hepatic fibrosis. This study was performed to evaluate the clinical significances of serum hyaluronic acid(HA) and type IV collagen(IV-C) levels on hepatic fibrosis in the patients with chronic viral hepatitis B and liver cirrhosis. Methods: This study included fifty eight patients with chronic viral liver diseases caused by HBV. Scheuer`s classification was used to determine the degree of hepatic fibrosis. The levels of hyaluronic acid and type IV collagen was evaluated by one-step sandwich binding protein assay and one-step sandwich enzyme immunoassay respectively. Results: The level of hyaluronic acid and type IV collagen in stage III(HA:589.4±193.7ng/ml, IV-C:444.5±221.3ng/ml) and IV(727.5±306.1ng/ml, IV-C:5192±210.5ng/ml) were higher than stage I(HA:207.2±206.8ng/ml, IV-C:210.0±92.0ng/ml) and II(HA:223.7±172.9ng/ml, IV- C:209.6±70.7ng/ml) in the patients with chronic viral hepatitis and cirrhosis. At cutoff value of 500ng/ml for HA and 250ng/ml for IV-C in chronic hepatitis B patients, the sensitivities were 85% and 85%, and specificities were 89.5% and 78.9%, and diagnostic efficiencies were 87.9% and 81% respectively for discriminating patients with advanced hepatic fibrosis(stageIII-IV) from those with mild hepatic fibrosis(stageI-II). Conclusion: The serum levels of hyaluronic acid and type IV collagen correlated significantly with the degree of hepatic fibrosis in the patients with chronic viral hepatitis B and cirrhosis. The serum hyaluronic acid and type IV collagen is useful biochemical markers for evaluating hepatic fibrosis and follow up of the patients with chronic viral hepatitis H and cirrhosis.