Serum hyaluronan and collagen IV as non-invasive markers of liver fibrosis in patients from an endemic area for schistosomiasis mansoni: a field-based study in Brazil

Memórias do Instituto Oswaldo Cruz

Carolina Coimbra Marinho¹  Thales Bretas¹  Izabela Voieta¹  Leonardo Campos De Queiroz¹  Raiza Ruiz-guevara²  Antônio Lúcio Teixeira¹  Carlos Maurício Antunes¹  Aluízio Prata²  José Roberto Lambertucci¹ 

[1] ,Faculdade de Medicina do Triângulo MineiroUberaba MG ,Brasil

关键词: schistosomiasis;    ultrasound;    liver fibrosis;    hepatosplenic schistosomiasis;    fibrosis markers;   

DOI  :  10.1590/S0074-02762010000400020

来源: SciELO

【 摘 要 】

Non-invasive markers of fibrosis have been used to diagnose liver fibrosis in a variety of diseases. Hyaluronic acid (HA) and collagen IV (C-IV) levels were measured in the sera of patients from an endemic area for schistosomiasis in Brazil to diagnose and to rank the intensity of liver fibrosis. Seventy-nine adult patients with schistosomiasis, in the age range of 21-82 years (49 ± 13.4) were submitted to clinical and ultrasonographic examinations. Ultrasound was employed to diagnose and categorise liver fibrosis according to World Health Organization patterns. Serum HA and C-IV levels were measured using commercial ELISA kits. Ultrasound revealed six patients with intense liver fibrosis, 21 with moderate, 23 with light and 29 without. Serum HA was able to separate individuals with fibrosis from those without (p < 0.001) and light from intense fibrosis (p = 0.029), but C-IV was not (p = 0.692). The HA diagnostic accuracy for fibrosis was 0.89. The 115.4 ng/mL cut-off level diagnosed patients with fibrosis (sensitivity 0.98, specificity 0.64). HA correlated positively with portal hypertension. Periportal fibrosis (subjective evaluation), age and collateral circulation predicted HA increase. In conclusion, we propose that serum HA can be used to identify patients with liver fibrosis in an endemic area for schistosomiasis mansoni in Brazil.

【 授权许可】

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