DIAGNOSTIC MARKERS OF PROGRESSION OF FIBROUS LIVER CHANGES IN PATIENTS WITH CHRONIC DIFFUSE LIVER DISEASES OF ALCOHOLIC GENESIS
DOI:
https://doi.org/10.11603/bmbr.2706-6290.2020.3.11295Keywords:
chronic diffuse liver diseases of alcoholic genesis, cytokines, biochemical markers of fibrosis, diagnostic valueAbstract
Summary. Today, the appearance of fibrosis is considered the most important histological change that determines the further course of chronic diffuse liver diseases of alcoholic etiology. Therefore, in clinical practice, non-invasive or minimally invasive markers are needed that would have high accuracy in assessing liver fibrosis.
The aim of the study – to determine the diagnostic value of cytokine profile indices and biochemical markers for stratification of the severity of liver fibrosis in patients with chronic diffuse liver diseases of alcoholic genesis.
Materials and Methods. 29 patients with chronic diffuse liver diseases of alcoholic genesis were examined. All patients underwent shear wave elastography, according to the results of which 7 patients had no liver fibrosis (F0), 13 patients were diagnosed with moderate fibrosis (F1-F2), and 9 patients had severe liver fibrosis (F3-F4). The serum levels of interleukin-6, interleukin-10, tumor necrosis factor-α, free hydroxyproline, protein-bound hydroxyproline and glycosaminoglycans were assessed in the blood serum of all patients.
Results. It was found that the stiffness of the liver parenchyma in patients without fibrosis was 4.3 kPa (4.1; 4.56), with moderate fibrosis – 6.9 kPa (6.0; 7.6), with severe fibrosis – 15.8 kPa (9.7; 20.3). The progression of fibrotic changes in the liver was accompanied by a significant increase in the level of interleukin-6 by 3 times (p<0.05) and tumor necrosis factor by 3.6 times (p<0.05) compared with patients without fibrotic changes. In 100.0 % of patients with severe hepatic fibrosis, activation of collagen synthesis was revealed, as evidenced by an increase in the content of protein-bound hydroxyproline in blood serum by 2 times (p<0.01) compared with patients without fibrosis and by 1.5 times (p<0.05) compared with patients with moderate liver fibrosis.
Conclusions. Diagnostically significant markers of pronounced liver fibrosis in patients with chronic diffuse liver diseases of alcoholic genesis are tumor necrosis factor-α levels over 2.1 pg/ml (sensitivity 81.8 %, specificity 75.0 %) and protein-bound hydroxyproline level over 260.5 μmol/l (sensitivity 85.7 %, specificity 72.7 %).
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