Objective: To study the relationship between the serum levels of hyaluronic acid (HA), procollagen type Ⅲ (PCⅢ), collagen type Ⅳ (CⅣ) and the histological degree of hepatic fibrosis evaluated by image analysis, and the clinical significance of serum HA, PCⅢ, CⅣ in the diagnosis of hepatic fibrosis in patients with chronic viral hepatitis.
Methods: The concentrations of serum HA, PCⅢ, CⅣ in 151 patients with chronic viral hepatitis were measured by radioimmunoassay. Liver biopsies were performed in all the patients. Histological sections of 4 μm thickness were stained with Masson’s trichrome for fibrosis assessment. Morphometric quantitative measurements for hepatic fibrosis assessment in the 4 μm sections were performed using a fully automated image analysis system. Serum levels of HA, PCⅢ, and CⅣ were analyzed at different stages of liver pathology and compared with the morphometric quantitative measurements of hepatic fibrosis.
Results: The serum levels of HA, PCⅢ, CⅣ all elevated gradually with the progression of the disease, and all reached the highest in patients with liver cirrhosis. There was a significant difference in the levels of these 3 components between liver cirrhosis group and the other groups (P<0.05). They all increased steadily with the histological stages of hepatic fibrosis, and reached the highest levels in stage IV. The serum levels of HA, PCⅢ, CⅣ were all positively correlated with the histological stages of liver sections and the morphometric measurement (P<0.001). The coefficients with stages were 0.694, 0.493, 0.552 (P<0.001), respectively and with surface density of total collagen on liver biopsy sections by image analysis were 0.715, 0.595, 0.573 (P<0.001), respectively.
Conclusion: The serum levels of HA, PCⅢ, CⅣ were in consistent with the degree of hepatic fibrosis, and the determination of these marks is valuable for detecting hepatic fibrosis.