CAN YKL-40 IMPROVE THE DIAGNOSTIC POWER OF NON-INVASIVE FIBROGENIC STAGING IN CHRONIC HEPATITIS B VIRUS INFECTED PATIENTS?

EL-Shahat A. Toson*, Gamal E. Shiha, EL-Sherbiny H. EL-Saied, Waleed Samir, Mohamed ELbasiony, Doaa A. Shoieb

ABSTRACT

Background: Chronic hepatitis B virus run the risk of developing fibrosis and in later life hepatocellular carcinoma. Aim: The aim is to test the diagnostic power of YKL-40 in assessing liver fibrosis and its ability to improve those of APRI, AGE/AST, AAR, FI, CDS, LOK, API, FIB4, FIBQ, GUCI and KING scores in the previous patients. Methods: Blood samples for complete blood count and serum for YKL-40, liver function tests, HBV DNA and HBV markers evaluation were taken (n=71, F0 - F4); beside, transient elastography. The numerical values of these scores were quantized and correlated with that of YKL-40. Results: YKL-40 can efficiently differentiate patients with non-significant (F0, F1) from those with significant fibrosis (F2 –F4); sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 86, 100, 100, 87 and AUC of 0.941, respectively and those with severe (F3 , F4) from non-severe fibrosis (F0 – F2, 95, 74, 60, 97 and 0.932, respectively). The additions of the results of YKL-40 to those of the previous scores greatly enhance their AUCs and their diagnostic power in the majority of cases. Conclusions: YKL-40, itself, cannot only help in assessing hepatic fibrosis but also dramatically enhance the diagnostic power of the tested scores in their non-invasive abilities to discriminate the stages of the disease in HBV chronically infected Egyptian patients.

Keywords: YKL-40, Liver fibrosis, Hepatitis B Virus, transient elastography, non-invasive scores.