Evaluation Of Serum Hyaluronic Acid And Matrix Metaloproteinase-2 As Non Invasive Markers Of Hepatic Fibrosis

Liver biopsy is currently the gold standard for assessing liver fibrosis and non reliable non invasive approach is available, therefore a suitable serologic Biomarker is needed. Several biochemical markers have shown promise for the detection of advanced fibrosis and cirrhosis. The aim of the present work is to study the diagnostic value of serum hyaluronic acid (SHA) and matrix metalloproteinase-2 (MMP-2) as indicators for the stage of hepatic fibrosis, and to correlate the liver pathology and liver function tests with serum fibrosis markers. Eighty treatment naive patients with chronic hepatitis C {[}CHC] with or without HBV and forty healthy subjects are used as a control group. The patients were divided according to Metavir classification of liver biopsy into 3 groups. Group 1 with normal biopsy (17 patients), group 2 was 35 patients with mild fibrotic changes (stage 1-2) and group 3 of 28 patients with severe fibrosis (stage 3-4). SHA level was significantly higher in patients with severe fibrosis than patients with mild or no hepatic fibrosis. (378.7 +/- 147.5, 226.2 +/- 123.7 and 85.3 +/- 52.2 pg/ml). (P<0.0001). MMP-2 was also significantly higher in severe fibrosis (group 3) than group 2 or group 1 (1196.2 +/- 119.5, 918.1 +/- 175.8 and 841.1 +/- 224.5 pg/ml) respectively (P<0.001). SHA and MMP-2 were not correlated to age, S bilirubin AST, ALT or spleen size. Group 3 was correlated significantly to the SHA and MMP, platelet count, S albumin and liver size but not correlated to AST, ALT, S. bilirubin or spleen size. The Specificity of fibrosis markers SHA and MMP-2 in prediction of severe fibrosis were 94.4\% and 90.0\% respectively and the sensitivity were higher to SHA 90.0\% than MMP-2 80\% but not a predictor of mild or normal biopsy. The cut of value of SHA, MMP-2, platelet count and prothrombin time (PT Activity), in diagnosis of severe fibrosis were 294.84 pg/ml, 1003 pg/ml., 115.084/cmmm, 72.116\% respectively. Measurement of SHA and MMP-2 can be used to differentiate cirrhotic from non-cirrhotic patient and can be regarded as a useful non invasive test in the diagnosis of liver cirrhosis. {[}Elham Ragab Abdel-Samea, Soma Sherif Abd El Gawad and Mohammed Abd El Hamid Ali: Evaluation of non invasive markers of hepatic fibrosis. Life Science Journal. 2011;8(2):19-25] (ISSN: 1097-8135). http://www.lifesciencesite.com.