Diagnostic value of TIMP-1, TIMP-2, TGF-beta 1, YKL-40 in the evaluation of liver fibrosis in patients with chronic hepatitis B

Objectives: To evaluate the diagnostic accuracy of noninvasive serological parameters to predict liver fibrosis in chronic hepatitis B patients Design: Prospective clinical study Setting: Ankara Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey Subjects: This study included 88 patients with chronic hepatitis B Intervention: Liver biopsy was performed in all patients. Fibrosis stage was determined using Ishak's scoring system. In group I, there were cases with mild or no fibrosis and group II had patients with severe fibrosis. Main outcome measures: Serum YKL-40, TIMP-1, TIMP-2, MMP-2 and TGF-beta 1 were measured by ELISA. Serological parameters were compared with histopathological fibrosis scores. Results: Group I included 55 patients (62.5%) and group II had 33 patients (37.5%). Serum YKL-40 were found higher in group II than group I (P=.034). There was no statistical difference in other serological parameters. We demonstrated that YKL-40 has highest area under the receiver operating characteristic for predicting >= F3 fibrosis. Based on the results, TIMP-1, TIMP-2, MMP-2, TGF-beta 1 levels are not useful in determining liver fibrosis in patients with chronic hepatitis B. However, YKL-40 values revealed correlation with histopathological parameters. Conclusion: We found that serum YKL-40 values can be used as an important non-invasive test for diagnosis of fibrosis in patients with chronic hepatitis B. However, we think that it was not yet enough to replace liver biopsy clinically.