PLATELETS, ASPARTATE AMINOTRANSFERASE, TUMOR NECROSIS FACTOR-α: LABORATORY PANEL FOR DIAGNOSIS OF LIVER FIBROSIS STAGE
https://doi.org/10.29001/2073-8552-2019-34-1-124-129
Abstract
Aim. To study significance of platelet count and values of aspartate aminotransferase and tumor necrosis factor-α in the evaluation of the severity of liver fibrosis in chronic hepatitis C and for the development of fibrosis index calculation formula.
Material and Methods. The study included 70 patients with chronic hepatitis C end 30 healthy persons. Liver density was estimated by ultrasound elastography.
Results. The correlation analysis revealed strong relationships between the ultrasound elastography findings of fibrosis stage and the platelet count (r=0.83), aspartate aminotransferase (r=0.83), and tumor necrosis factor-α (r=0.81). The optimal separation points of laboratory tests for fibrosis exclusion were identified as follows: platelet count>270×109 /L (test sensitivity=96.2%), aspartate aminotransferase level<44 E/L (sensitivity=96.2%), and tumor necrosis factor-α concentration below 1.9 pg/mL (sensitivity=92.3%). The obtained values of laboratory parameters were used for calculation of the liver fibrosis index. The value of the fibrosis index ranging between 0 and 0.5 indicated the absence of fibrosis (stage F0), the value of the fibrosis index ranging between 0.6 and 2.5 corresponded to the moderate stage of fibrosis (F1-2), and the value of the fibrosis index>2.5 corresponded to the severe fibrosis/cirrhosis of the liver (F3-4) with diagnostic sensitivity of 83% and specificity of 78%.
Conclusion. Platelet count, the values of aspartate aminotransferase and tumor necrosis factor-α levels, fibrosis index, and laboratory test data can be used for ruling out fibrosis in chronic hepatitis C patients as well as for stratification of liver fibrosis stages.
About the Authors
A. P. Shchekotova
Perm State Medical University named after Academician E. A. Wagner
Russian Federation
Russian Federation
Dr. Sci. (Med.), Professor, Head of the Department of Clinical Laboratory Diagnostics Faculty, Faculty of Continuous Medical Education,
26, Petropavlovskaya str., Perm, 614000
I. A. Bulatova
Perm State Medical University named after Academician E. A. Wagner
Russian Federation
Russian Federation
Dr. Sci. (Med.), Professor of the Department of Clinical Laboratory Diagnostics Faculty, Faculty of Continuous Medical Education,
26, Petropavlovskaya str., Perm, 614000
D. Yu. Sosnin
Perm State Medical University named after Academician E. A. Wagner
Russian Federation
Russian Federation
Dr. Sci. (Med.), Professor of the Department of Clinical Laboratory Diagnostics Faculty, Faculty of Continuous Medical Education,
26, Petropavlovskaya str., Perm, 614000
Yu. I. Tretyakova
Perm State Medical University named after Academician E. A. Wagner
Russian Federation
Russian Federation
Cand. Sci. (Med.), Associate Professor of the Department of Policlinic Therapy,
26, Petropavlovskaya str., Perm, 614000
References
1. Wynn А. Cellular and molecular mechanisms of fibrosis. J. Pathol. 2008; 214(2): 199–210. doi: 10.1002/path.2277.
2. Saffioti F., Pinzani M. Development and Regression of Cirrhosis. Dig Dis. 2016;34(4):374–381. https://doi: 10.1159/000444550
3. Baranova A., Lal P., Birerdinc A., Younossi Z.M. Non-invasive markers for hepatic fibrosis. BMC Gastroenterol. 2011;11:91. https://doi: 10.1186/1471-230x-11-91
4. Sandrin L., Fourquet B., Hasquenoph J.M., Yon S., Fournier C., Mal F. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med. Biol. 2003;29:1705–1713. http://dx.doi.org/10.1016/j.ultrasmedbio.2003.07.001.
5. Chou R., Wasson N. Blood tests to diagnose fibrosis or cirrhosis in patients with chronic hepatitis C virus infection: a systematic review. Ann. Intern. Med. 2013;158:807–820. DOI: 10.7326/0003-4819-158-11-201306040-00005.
6. Shchyokotova A.P., Bulatova I.A., Rojtman A.P. Chuvstvitel’nost’ i specifichnost’ opredeleniya gialuronovoj kisloty, koehfficienta de Ritisa i VEFR dlya diagnostiki HG i CP. Permskij medicinskij zhurnal. 2013;4(30):84–89 (In Russ.).
7. Poynard T., Morra R., Halfon P., Castera L., Ratziu V., Imbert-Bismut F., et al. Meta-analyses of FibroTest diagnostic value in chronic liver disease. BMC Gastroenterol. 2007;7:40–51. DOI: 10.1186/1471- 230x-7-40.
8. Williams A.L., Hoofnagle J.H. Ratio of serum aspartate to alanine aminotransferase in chronic hepatitis. Relationship to cirrhosis. Gastroenterol. 1988;95(3):734–739.
9. Pinzani M., Rombouts К., Colagrande S. Fibrosis in chronic liver diseases: diagnosis and management. J. Hepatol. 2005;42:22–36.
10. Bulatova I.A. Fibroz pri hronicheskih zabolevaniyah pecheni: mekhanizmy razvitiya, kliniko-laboratornaya ocenka progressirovaniya i monitoring terapii. Avtoref dis. … dokt. med. nauk. Perm’; 2016:50 (In Russ.).
11. Levitan B.N., Astahin A.V., Levitan G.B. Faktor nekroza opuholi i ego rastvorimye receptory pri hronicheskih gepatitah i cirrozah pecheni. Ehksperimental’naya i klinicheskaya gastroehnterologiya. 2017;2(138):62–66 (In Russ.).
12. Lin Z.H., Xin Y.N., Dong Q.J., Wang Q., Jiang X.J., Zhan S.H., et al. Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis: an updated meta-analysis. J. Hepatol. 2011;53:726–736.
13. Sebastiani G., Vario A., Guido M. Noninvasive assessment of liver fibrosis. Ann. Gastroenterol. 2012;3(25):218–231.
Review
For citations:
Shchekotova A.P., Bulatova I.A., Sosnin D.Yu., Tretyakova Yu.I. PLATELETS, ASPARTATE AMINOTRANSFERASE, TUMOR NECROSIS FACTOR-α: LABORATORY PANEL FOR DIAGNOSIS OF LIVER FIBROSIS STAGE. Siberian Journal of Clinical and Experimental Medicine. 2019;34(1):124-129. (In Russ.) https://doi.org/10.29001/2073-8552-2019-34-1-124-129
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