ROC curves in evaluation of serum fibrosis indices for hepatic fibrosis

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:zhk42
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AIM:Use Receiver operating characteristic(ROC)curves tofind out the relationship between serum level of hyaluronicacid(HA),type Ⅲ procollagen(PCⅢ),N-terminalprocollagen Ⅲ peptide(PⅢNP),laminin(LN),type Ⅳcollagen(C-Ⅳ)and hepatic fibrosis,as well as to determinetheir value in clinical practice.METHODS:114 serum samples from chronic hepatitispatients were assayed for fibrosis indices including HA,PCⅢ,PⅢNP,LN and Ⅳ-C with radioimmunoassay(RIA).Liverbiopsy was also performed in all these patients and thebiopsy material was examined histopathologically.RESULTS:ROC curves analysis showed that area under thecurve(AUC)of PⅢNP,HA,PCⅢ,C-Ⅳ and LN was 0.800,0.728,0.727,0.583 and 0.463,respectively.The analysisalso showed that PⅢNP(r=0.452),HA(r=0.497)and PCⅢ(r=0.404)have greater diagnosis performances than C-Ⅳ(r=0.238)and LN(r=0.128)according to fibrosis staging.The sensitivity of HA plus PIIINP was 55.1%,it was themost sensitive combination.Combined three or more thanthree indices that based on HA,the specificity was 100 %.Using combination assays can improve the specificity,butits sensitivity was not high.Serum fibrosis indices increasedas the grade of inflammation aggravated.But only PⅢNPand PCⅢ had significant difference between G1 and G2(PⅢNP:13.16±8.07 vs8.32±5.09;PCⅢ:164.22±65.69 vs138.23±77.63).The coefficient correlation of the results ofinflammation grade and fibrosis staging to HA was 0.525and 0.553 respectively,that to PCⅢ,0.446 and 0.412,thatto LN,0.234 and 0.194,and that to Ⅳ-C,0.363 and 0.351,respectively.CONCLUSION:Serum fibrosis indices can indicate tendencyof hepatic fibrosis,but it cannot replace liver biopsy.However,as diagnostic markers,more efficient serum fibrosisindices for the diagnosis of hepatic fibrosis need to beexplored. AIM: Use Receiver operating characteristic (ROC) curves tofind out the relationship between serum level of hyaluronic acid (HA), type III procollagen (PCIII), N-terminal protocollagen III peptide ) and hepatic fibrosis, as well as determine the value of their in clinical practice. METHODS: 114 serum samples from chronic hepatitispatients were assayed for fibrosis indices including HA, PCIII, PIIINP, LN and IV-C with radioimmunoassay (RIA) .Liverbiopsy was also performed ROC curves were analyzed for that area under the curve (AUC) of PIIINP, HA, PCIII, C-IV and LN was 0.800, 0.728, 0.727, 0.583 and 0.463 respectively. analysisalso showed that PⅢNP (r = 0.452), HA (r = 0.497) and PCⅢ (r = 0.404) have greater diagnostic performances than C-Ⅳ (r = 0.238) and LN of HA plus PIIINP was 55.1%, it was themost sensitive combination. Combined three or more than three indices that based on HA, the specificity was 100% .Using combination assays can improve the specificity, butits sensitivity was not high. Serum fibrosis indices increasedas the grade of inflammation aggravated.But only PⅢNPand PCⅢ had significant difference between G1 and G2 (PⅢNP : 13.16 ± 8.07 vs 8.32 ± 5.09; PCⅢ: 164.22 ± 65.69 vs138.23 ± 77.63). The coefficient correlation of the results of inflammation grade and fibrosis staging to HA was 0.525 and 0.553 respectively, that to PC III, 0.446 and 0.412, that to LN, 0.234 and 0.194, and that to IV-C, 0.363 and 0.351, respectively. CONCLUSION: Serum fibrosis indices can indicate tendency of hepatic fibrosis, but it can not replace liver biopsy. Still, as diagnostic markers, more efficient serum fibrosisindices for the diagnosis of hepatic fibrosis need to beexplored.
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