Combined detection of liver stiffness and C-reactive protein in patients with hepatitis B virus-related liver cirrhosis, with and without hepatocellular carcinoma

Liu,Xiao‑Yan; Ma,Li‑Na; Yan,Ting‑Ting; Lu,Zhen‑Hui; Tang,Yuan‑Yuan; Luo,Xia; Ding,Xiang‑Chun

doi:10.3892/mco.2016.742

Combined detection of liver stiffness and C-reactive protein in patients with hepatitis B virus-related liver cirrhosis, with and without hepatocellular carcinoma

Authors:
- Xiao‑Yan Liu
- Li‑Na Ma
- Ting‑Ting Yan
- Zhen‑Hui Lu
- Yuan‑Yuan Tang
- Xia Luo
- Xiang‑Chun Ding
View Affiliations

Affiliations: Department of Infectious Diseases, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China, Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China, Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
Published online on: January 26, 2016 https://doi.org/10.3892/mco.2016.742
Pages: 587-590

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of the present study was to investigate the usefulness of combined detection of liver stiffness (LS) and serum C‑reactive protein (CRP) level in patients with hepatitis B virus (HBV)‑related liver cirrhosis (LC). A total of 156 cases of previously untreated patients with HBV‑related LC were classified into the LC group [LC without hepatocellular carcinoma (HCC)] and the HCC group (LC with HCC). Comparative analyses of LS and serum CRP level were conducted between these two groups. LS values and serum CRP levels were found to be significantly higher in the HCC group compared with those in the LC group (P<0.01). The LS values and serum CRP levels were not significantly different between α‑fetoprotein (AFP)‑positive and ‑negative patients. A high LS value was a high‑risk factor for HCC in patients with chronic hepatitis B. the CRP‑positive rate was significantly higher in the HCC group compared with that in LC group in a subset of patients with high LS values (P<0.01). In conclusion, the combined detection of LS and serum CRP may complement the measurement of AFP in the diagnosis of HBV‑related HCC, improve the identification of patients with AFP‑negative HCC and help distinguish HCC from LC.

View Figures

View References

1	El-Serag HB: Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology. 142:1264–1273. 2012. View Article : Google Scholar : PubMed/NCBI
2	Luk JM and Liu AM: Proteomics of hepatocellular carcinoma in Chinese patients. OMICS. 15:261–266. 2011. View Article : Google Scholar : PubMed/NCBI
3	Lin CL and Kao JH: Risk Stratification for hepatitis B virus related hepatocellular carcinoma. J Gastroenterol Hepatol. 28:10–17. 2013. View Article : Google Scholar : PubMed/NCBI
4	Gao Y, Jiang Q, Zhou X, Ding B, Wang R, Zhao G and Chen Y: HBV infection and familial aggregation of liver cancer: An analysis of case-control family study. Cancer Causes Control. 15:845–850. 2004. View Article : Google Scholar : PubMed/NCBI
5	Siegel R, Naishadham D and Jemal A: Cancer statistics, 2013. CA Cancer J Clin. 63:11–30. 2013. View Article : Google Scholar : PubMed/NCBI
6	Cabrera R, Fitian AI, Ararat M, Xu Y, Brusko T, Wasserfall C, Atkinson MA, Liu C and Nelson DR: Serum levels of soluble CD25 as a marker for hepatocellular carcinoma. Oncol Lett. 4:840–846. 2012.PubMed/NCBI
7	Masuzaki R, Karp SJ and Omata M: New serum markers of hepatocellular carcinoma. Semin Oncol. 39:434–439. 2012. View Article : Google Scholar : PubMed/NCBI
8	Marcellin P, Ziol M, Bedossa P, Douvin C, Poupon R, de Lédinghen V and Beaugrand M: Non-invasive assessment of liver fibrosis by stiffness measurement in patients with chronic hepatitis B. Liver Int. 29:242–247. 2009. View Article : Google Scholar : PubMed/NCBI
9	do Kim Y, Kim SU, Ahn SH, Park JY, Lee JM, Park YN, Yoon KT, Paik YH, Lee KS, Chon CY, et al: Usefulness of FibroScan for detection of early compensated liver cirrhosisin chronic hepatitis B. Dig Dis Sci. 54:1758–1763. 2009. View Article : Google Scholar : PubMed/NCBI
10	Chan HL, Wong GL, Choi PC, Chan AW, Chim AM, Yiu KK, Chan FK, Sung JJ and Wong VW: Alanine aminotransferase-based algorithms of liver stiffness measurement by transient elastography (Fibroscan) for liver fibrosis in chronic hepatitis B. J Viral Hepat. 16:36–44. 2009. View Article : Google Scholar : PubMed/NCBI
11	Vizzutti FI, Arena U, Romanelli RG, Rega L, Foschi M, Colagrande S, Petrarca A, Moscarella S, Belli G, Zignego AL, et al: Liver stiffness measurement predicts severe portal hypertension in patients with HCV-related cirrhosis. Hepatolog. 45:1290–1297. 2007. View Article : Google Scholar
12	Cescon M, Colecchia A, Cucchetti A, Peri E, Montrone L, Ercolani G, Festi D and Pinna AD: Value of transient elastography measured with FibroScan in predicting the outcome of hepatic resection for hepatocellular carcinoma. Ann Surg. 256:706–712; discussion 712–713. 2012. View Article : Google Scholar : PubMed/NCBI
13	Masuzaki R, Tateishi R, Yoshida H, Goto E, Sato T, Ohki T, Imamura J, Goto T, Kanai F, Kato N, et al: Prospective risk assessment for hepatocellular carcinoma development in patients with chronic hepatitis C by transient elastography. Hepatology. 49:1954–1961. 2009. View Article : Google Scholar : PubMed/NCBI
14	Jung KS, Kim SU, Ahn SH, Park YN, do Kim Y, Park JY, Chon CY, Choi EH and Han KH: Risk assessment of hepatitis B virus-related hepatocellular carcinoma development using liver stiffness measurement (FibroScan). Hepatology. 53:885–894. 2011. View Article : Google Scholar : PubMed/NCBI
15	Fung J, Lai CL, Seto WK, Wong DK and Yuen MF: Prognostic significance of liver stiffness for hepatocellular carcinoma and mortality in HBeAg-negative chronic hepatitis B. J Viral Hepat. 18:738–744. 2011. View Article : Google Scholar : PubMed/NCBI
16	Chon YE, Jung ES, Park JY, do Kim Y, Ahn SH, Han KH, Chon CY, Jung KS and Kim SU: The accuracy of noninvasive methods in predicting the development of hepatocellular carcinoma and hepatic decompensation in patients with chronic hepatitis B. J Clin Gastroenterol. 46:518–525. 2012. View Article : Google Scholar : PubMed/NCBI
17	Shameem M, Bhargava R, Ahmad Z, Saad T, Fatima N and Malik A: Association between serum C-reactive protein levels and other important predictive markers of outcome in COPD. Acta Med Iran. 49:18–20. 2011.PubMed/NCBI
18	Tasxi C, Balkan A, Karadurmus N, Inal S, Kilic S, Ozkan M, Bilgic H and Ekiz K: The importance of serum procalcitonin levels in patients with chronic obstructive pulmonary disease exacerbations. Turk J Med Sci. 38:139–144. 2008.
19	Garcia-Rio F, Miravitlles M, Soriano JB, Muñoz L, Duran-Tauleria E, Sánchez G, Sobradillo V and Ancochea J: EPI-SCAN Steering Committee: Systemic inflammation in chronic obstructive pulmonary disease: A population-based study. Respir Res. 11:632008. View Article : Google Scholar
20	Peisajovich A, Marnell L, Mold C and Du Clos TW: C-reactive protein at the interface between innate immunity and inflammation. Expert Rev Clin Immunol. 4:379–390. 2008. View Article : Google Scholar : PubMed/NCBI
21	Dinarello CA: The acute phase response. Cecil Textbook of Medicine (20th). Bennett JC and Plum F: WB Saunders Co. 1535–1537. 1996.
22	Andreozzi P, Viscogliosi G, Colella F, Subic M, Cipriani E, Marigliano B, Verrusio W, Servello A, Ettorre E and Marigliano V: Predictors of liver fibrosis in patients with non-alcoholic fatty liver disease. The role of metabolic syndrome, insulin-resistance and inflammation. Recenti Prog Med. 103:570–574. 2012.PubMed/NCBI
23	Ma LN, Liu XY, Luo X, Hu YC, Liu SW, Tang YY, Pan JL and Ding XC: Serum high-sensitivity C-reactive protein are associated with HBV replication, liver damage and fibrosis in patients with chronic hepatitis B. Hepatogastroenterology. 62:368–372. 2015.PubMed/NCBI
24	Atta M, Cabral M, Santos G, Paraná R and Atta A: Inflammation biomarkers in chronic hepatitis C: Association with liver histopathology, HCV genotype and cryoglobulinemia. Inflamm Res. 61:1101–1106. 2012. View Article : Google Scholar : PubMed/NCBI
25	Sjöwall CI, Cardell K, Boström EA, Bokarewa MI, Enocsson H, Ekstedt M, Lindvall L, Frydén A and Almer S: High prevalence of autoantibodies to C-reactive protein in patients with chronic hepatitis C infection: association with liver fibrosis and portal inflammation. Hum Immunol. 73:382–388. 2012. View Article : Google Scholar : PubMed/NCBI
26	Nishikawa H, Arimoto A, Wakasa T, Kita R, Kimura T and Osaki Y: Pre-treatment C-reactive protein as a prognostic factor for recurrence after surgical resection of hepatocellular carcinoma. Anticancer research. 33:1181–1188. 2013.PubMed/NCBI
27	Chen W, Wang JB, Abnet CC, Dawsey SM, Fan JH, Yin LY, Yin J, Taylor PR, Qiao YL and Freedman ND: Association between C-reactive protein, incident liver cancer, and chronic liver disease mortality in the Linxian Nutrition Intervention Trials: A nested case-control study. Cancer Epidemiol Biomarkers Prev. 24:386–392. 2015. View Article : Google Scholar : PubMed/NCBI
28	Zhao X, Luo J, Li B, Liu S and Li D: The association between preoperative serum C-reactive protein and hepatocellular carcinoma recurrence in patients with chronic hepatitis B virus (HBV) infection-a retrospective study. PLoS One. 10:e01169092015. View Article : Google Scholar : PubMed/NCBI
29	Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association: The guideline of prevention and treatment for chronic hepatitis B (2010 version). Chin J Hepatol. 19:13–24. 2011.(In Chinese).