Predictive value of serum aminoterminal type III procollagen peptide levels, serum laminin levels, and liver membrane antibodies for prognosis of chronic hepatitis.
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Serum concentration of aminoterminal type III procollagen peptide (P3P) and laminin have been shown as serum markers of liver fibrosis. In addition, liver membrane antibody (LMA) is suggested to play a role in the pathogeneis of chronic hepatitis. However, it is not known whether these serum markers are useful to predict the prognosis of chronic hepatitis. To test this, we measured P3P, laminin, and LMA in sera at the time of liver biopsies in 43 patients with chronic hepatitis who had serial liver biopsies more than two times during the 2-81 months (mean 25 months) follow-up period. Serum contents of P3P and laminin were measured by radioimmunoassay. Serum LMA was measured by radioimmunoassay according to the method of Thomas et al. The histological grading of liver fibrosis and of inflammation were scored according to Histology Activity Index by Knodell et al. Among thirty-two patients who had liver biopsies during 12-55 months, 16 patients showed histological progression on their latest liver biopsies compared with the first biopsies (Group 1). At the first biopsies, serum P3P levels were significantly higher in Group 1 than in 16 patients without histological progression (Group 2) (p<0.05). However, no difference were observed in serum laminin levels and in serum LMA between the two groups. Serum laminin levels were significantly correlated with the histological scores of fibrosis (comparison chisq=0.0089, df=2, p=0.995584) and inflammation (comparison chisq=21.4103, df=4, p=0.000263), respectively. In addition, serum P3P levels showed no correlation with the histological scores.Serum P3P levels are suggested to be a useful serum marker to predict the prognosis of patients with chronic hepatitis. However serum laminin levels and LMA in sera have no predictive value; instead, serum laminin levels reflect the degree of liver fibrosis and inflammation at the time of serum sampling.
- 財団法人 日本消化器病学会の論文