846. Usefulness of Serum Markers for Predicting Liver Cirrhosis in Patients with Chronic Hepatitis B

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846. Usefulness of Serum Markers for Predicting Liver Cirrhosis in Patients with

Chronic Hepatitis B

K. Lee; Y. Seo; H. An; E. Jung; B. Keum; Y. Kim; H. . Yim; Y. Jeen; H. Chun; C.

Kim; H. Ryu; S. Um

Background and Aims:

Liver biopsy is still considered as the gold standard method for the evaluation

of liver cirrhosis. However, there are several limitations. It is an invasive

method that is associated with patient discomfort and in some case with serious

complication of bleeding and infection. In addition, its accuracy is limited by

sampling errors and inter- or intra-observer variability. Recently, various

serum markers were proposed for non-invasive methods for predicting liver

fibrosis stage. However, most of the studies were performed about chronic

hepatitis C patients and the studies about chronic hepatits B patients are

insufficient. This study was performed to evaluate the significance of various

noninvasive markers for predicting cirrhosis in chronic hepatitis B patients.

Methods:

Liver biopsy was performed in 125 chronic hepatitis B patients. In this

patients, WBC, platelet count, prothrombin time (PT), AST, ALT, GGT, ALP, total

bilirubin, albumin, cholesterol, glucose, haptoglobin, apolipoprotein A-1

(apo-A1), á2-macroglobulin, MMP-2, TIMP-1, YKL-40, MMP-9, and procollagen III

N-terminal peptide were measured on the biopsy-performed day. Fibrosis stage was

assessed according to METAVIR system. All patients were divided into two groups:

chronic hepatitis group, fibrosis stage F0-3; cirrhosis group, F4.

Results:

Among 125 patients with chronic hepatitis B, 34 patients (27.2%) were diagnosed

as liver cirrhosis on liver biopsy. Age, platelet count, WBC count, AST, ALT,

haptoglobin, apo-A1, MMP-2, and YKL-40 were significantly different between

chronic hepatitis group and cirrhosis group by univariate analysis. By

multivariate analysis, platelet count, AST, haptoglobin, and apo-A1 were

independent predictive factors for liver cirrhosis. With these four factors, we

made a new scoring system (PAHA index). PAHA indices were significantly

different between chronic hepatitis group and liver cirrhosis group (3.6±2.3 and

6.8±1.9, respectively; P