Non-Invasive Assessment of Liver Fibrosis Compared with Liver Biopsy Findings
- VernacularTitle:Инвазив бус аргуудаар элэгний фиброзын зэргийг таамаглаж элэгний биопсийн үр дүнтэй харьцуулан судлах нь
- Author:
Khas A
1
;
2
;
Suvdaa B
1
;
Gantogtokh D
3
;
Ulzmaa G
2
;
Batbold B
3
Author Information
1. Department of Hystology, School of Biomedicine, MNUMS
2. Department of Gastroenterology, TSCH
3. Institute of Medical Sciences, Ministry of Economy and Development
- Publication Type:Journal Article
- Keywords:
Liver fibrosis, METAVIR, MMP-1, MMP-2, PIIINP
- From:
Mongolian Journal of Health Sciences
2025;90(6):27-31
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:In our country, the high prevalence of chronic liver diseases is influenced by factors such as hepatotoxic
viruses, excessive alcohol and drug consumption, and a high incidence of obesity among the population. Although the
point at which liver fibrosis becomes irreversible remains unclear, some researchers have suggested, based on clinical
studies, that fibrosis may still be reversible in the early stages of cirrhosis.
Aim:Therefore, in this study, we aimed to evaluate the degree of liver fibrosis using key markers involved in the pathogenesis
of hepatic scarring—MMP-1 (matrix metalloproteinase-1), MMP-2 (matrix metalloproteinase-2), and PIIINP
(N-terminal propeptide of type III procollagen)—as well as non-invasive serum markers of hepatocyte injury (APRI and
FIB-4), and to compare these findings with the results of liver biopsy.
Materials and Methods:This analytical case-control study included 50 patients in the State Third Central Hospital. Peripheral
blood samples were analyzed for platelet count, aspartate aminotransferase (AST), and alanine aminotransferase
(ALT) using a fully automated analyzer, while serum direct markers were measured using ELISA. Non-invasive serum
markers (APRI and FIB-4) were calculated using the MD+CALC online system. Liver tissue for histological examination
was obtained via biopsy, and the degree of liver fibrosis was assessed according to the METAVIR scoring system.
Differences in mean values of quantitative variables between two groups were analyzed using the Mann-Whitney U test
was applied. The correlation between METAVIR stages and serum markers was evaluated using Spearman’s correlation.
Results:Among the study participants, according to the METAVIR classification, 15 individuals (30%) had no or minimal
fibrosis (F0–F1), 26 individuals (52%) had significant fibrosis without cirrhosis (F2–F3), and 9 individuals (18%)
had cirrhosis (F4). As the stage of fibrosis increased, the mean levels of AST (r=0.326, p=0.021), ALT (r=0.392, p=0.005),
MMP-2 (r=0.393, p=0.005), PIIINP (r=0.472, p=0.001), as well as APRI (r=0.503, p<0.001) and FIB-4 (r=0.482, p<0.001)
showed an increasing trend. In contrast, mean platelet count (r=–0.507, p<0.001) and MMP-1 (r=–0.383, p=0.006) decreased
with advancing fibrosis stages. Using AUC-ROC analysis to assess the diagnostic performance of both direct and
indirect serum markers, the ability to detect significant fibrosis and cirrhosis was estimated as follows: APRI 80%, FIB-4
75%, MMP-1 67.1%, MMP-2 72.2%, and PIIINP 72.3%.
Conclusion:In our study, the diagnostic performance of both direct and indirect serum markers for predicting liver fibrosis
exceeded 65%. Mean levels of AST, ALT, MMP-2, PIIINP, APRI, and FIB-4 increased with advancing fibrosis stages,
whereas mean platelet counts and MMP-1 levels decreased.
- Full text:2025121013113034048Инвазив бус аргуудаар элэгний фиброзын зэргийг таамаглаж элэгний биопсийн үр дүнтэй харьцуулан судлах нь.pdf
