Fibrosis assessment in chronic hepatitis B (CHB) is essential for prediction of long-term prognosis and proper treatment decision. This study was conducted to assess predictability of 5 simple noninvasive fibrosis indexes in comparison to liver biopsy in CHB patients.A total of 200 CHB adult Egyptian patients were consecutively included in this study, all were subjected to liver biopsy with staging of fibrosis using METAVIR scoring system. Fibrosis indexes including S-index, red cell distribution width to platelets ratio index (RPR), fibrosis-4 index (Fib-4), AST to platelets ratio index (APRI), and AST/ALT ratio index (AAR) were compared to biopsy result and their predictabilities for the different fibrosis stages were assessed using area under receiver operating characteristic curve (AUROC) analysis.S-index showed the highest AUROCs for predicting fibrosis among the studied indexes. AUROCs of S-index, RPR, Fib-4, APRI, and AAR were: 0.81, 0.67, 0.70, 0.68, and 0.60 for prediction of significant fibrosis (F2–F4), 0.90, 0.66, 0.68, 0.67, and 0.57 for advanced fibrosis (F3–F4), and 0.96, 0.62, 0.61, 0.57, and 0.53 for cirrhosis (F4), respectively. The optimal S-index cutoff for ruling in significant fibrosis was ≥0.3 with 94% specificity, 87% PPV, and 68% accuracy, while that for ruling out significant fibrosis was <0.1 with 96% sensitivity, 91% NPV, and 67% accuracy. Accuracy of S-index was higher for predicting cirrhosis (91%) than that for predicting advanced fibrosis (79%) and significant fibrosis (68%).S-index has the highest predictability for all fibrosis stages among the studied fibrosis indexes in HBeAg-negative CHB patients, with higher accuracy in cirrhosis than in the earlier fibrosis stages.
ObjectivesThe aim of this study was to assess serum levels of endocan & VEGF in patients with hepatitis C virus-related HCC and their diagnostic and predictive value of mortality.MethodsA total of 195 patients with CHC were subdivided into the following two groups: 105 HCV cirrhotic patients with HCC and 90 HCV cirrhotic patients without HCC. Sixty apparently healthy subjects served as the control group. The serum VEGF and endocan were assessed by ELISA.ResultsThe mean serum endocan level was 4257.6± 847.6 pg/mL in HCC patients, compared to 2099.2± 459.6 pg/mL in liver cirrhosis patients without HCC. VEGF levels in the HCC group were non-significantly higher than those of the non-HCC group, and control group. Endocan at cut-off value 2967 pg/ml had higher sensitivity and higher specificity in diagnosis of HCC than AFP and VEGF. The median follow up period was 9 months, survival curve analysis was done in HCC group and showed that probability of survival among HCC group with higher levels of VEGF and endocan were significantly lower than that patients with low levels. In HCC patients, elevated serum endocan levels were significantly associated with poor hepatic functions and a greater number and size of tumours. Multivariate analysis showed that serum endocan levels (≥4000 pg/ml), as well as elevated serum fetoprotein (>100 ng/dl), were independent prognostic biomarkers for mortality.ConclusionEndocan may be a useful diagnostic marker for HCC and a good predictor of mortality, especially when combined with AFP and VEGF.
Abstract. The present study aimed to examine the predictability of pre-treatment serum levels of interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α for determining the outcome of patients with nasopharyngeal carcinoma (NPC) assigned for chemoradiotherapy. A total of 35 patients with NPC were subjected to clinical examination and evaluation of performance status using Karnofsky scoring. Nasopharyngoscopy was performed for evaluation and to obtain a biopsy. Blood samples were obtained pre-and post-treatment for polymerase chain reaction quantitative estimation of Epstein-Barr virus (EBV) DNA plasma load and enzyme-linked immunosorbent assay for estimation of serum cytokines. All patients received chemoradiotherapy and were followed-up for 2 years. Cervical lymphadenopathy and recurrent attacks of epistaxis are the most common presenting symptoms. Treatment significantly decreased pre-treatment plasma EBV DNA load and serum levels of IL-6 and TNF-α, and increased serum IL-1β levels. Clinical staging and EBV DNA plasma load revealed positively significant correlation with pre-treatment serum levels of both IL-6 and TNF-α, while revealed negative significant correlation with serum IL-1β levels. The 2-year survival rate was negatively significantly correlated with pre-treatment levels of IL-6 and TNF-α, and EBV DNA viral load, while it was positively significantly correlated with pre-treatment performance scores and serum IL-1β levels. Statistical analyses defined high pre-treatment serum IL-6 levels as a significant specific predictor for high mortality rate. It was demonstrated that NPC was associated with high pre-treatment plasma EBV DNA load and serum cytokines, and chemoradiotherapy significantly reduced these high levels. High pre-treatment serum IL-6 level was a significant specific predictor for high mortality rate. Increased post-treatment serum levels of IL-1β indicated good therapeutic response and most probably a high survival rate.
Background: Pentraxins are generally considered acute phase proteins. Pentraxin 3 (PTX3), a long pentraxin, has been identified as an inflammatory biomarker, and its blood levels increase rapidly and dramatically in inflammatory conditions. Elevated plasma PTX3 levels were reported in patients with high systolic and diastolic blood pressures, and PTX3 can be an early marker of arteriosclerotic vascular damage. Carotid artery intima-media thickness (cIMT) is a well-established surrogate marker for subclinical atherosclerosis. However, the association between biomarkers of systemic inflammation and atherosclerosis progression in carotid artery is not well established. Aim of Study: Was to evaluate the value of plasma PTX3 level as a predictor for asymptomatic preclinical hypertensive-related atherosclerotic vascular disease. Subjects and Methods: 75 patients with primary hypertension who had no history or manifestations suggesting atherosclerotic vascular disease and 15 healthy subjects (control group) were included. Full history taking and thorough medical examination were done. Patients' weight, height, BMI, and blood pressure were assessed. Laboratory investigations (urine analysis, UACR, CBC, ESR, CRP, liver enzymes, urea, creatinine, blood sugar levels, HbA1c, uric acid, LDL cholesterol, HDL cholesterol, triglyceride, and PTX3 levels), ECG, echocardiography, and carotid ultrasonography (for measuring cIMT) were performed for all patients. Results: The mean age of patients was 54.7±9.3 years (range, 38-73 years). Asymptomatic preclinical atherosclerotic vascular disease, as reflected by cIMT > 0.1cm, was reported in 39 patients (52%). Hypertensive patients with LDL cholesterol ≥ 100mg/dL or with HDL cholesterol < 50mg/dL for males and < 40mg/dL for females had significantly higher plasma PTX3 levels. Higher degrees of UACR and albuminuria were associated with significantly elevated plasma PTX3 levels. Plasma PTX3 levels were significantly higher in hypertensive patients with preclinical atherosclerotic vascular disease,
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