Significance of Cytokeratin 18 as a Marker of Progression of Fatty Liver Disease and Chronic Hepatitis
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- Category: Vol. 85, March 2017
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Significance of Cytokeratin 18 as a Marker of Progression of Fatty Liver Disease and Chronic Hepatitis, ASHRAF METWALLY, EHAB F. MOSTAFA, NAGWA SHAWKY, HEBA SAMIR and MAGDY ISMAEL
Abstract
Background and Aim of the Work: Non-Alcoholic Fatty Liver Disease (NAFLD) is hepatic steatosis in the absence of other causes of hepatic fat accumulation, ranging from simple steatosis to Nonalcoholic Steatohepatitis (NASH). Liver biopsy is the gold standard for diagnosis of NAFLD however; it is invasive and carries non negligible risk. Cytokeratin 18 (CK18) is an inflammatory marker that can be used as a non-invasive method for diagnosis of NASH. This study aims at investigating the clinical performance of CK-18 as predictor of inflammation and fibrosis in patients with NASH.
Patients and Methods: This study included four groups Group I: 40 patients with chronic viral hepatitis, Group II: 20 patients with NAFLD, Group III: 20 patients with NASH, Group IV: 10 healthy control subjects. They were compared to each other as regards laboratory parameters, liver biopsy and CK-18 level.
Results: Group III had the highest CK-18 level followed by Group II (312.9±186.14 and 241.1±205.09IU/L successive-ly). There was a significant positive correlation between CK-18 level and fibrosis, activity and steatosis grades in biopsy in all test groups. At a cut off value of 91.5IU/L CK 18 was able to predict activity and steatosis with sensitivity of 91.2% and 95.4% and specificity of 70% and 72% successively. At a cut off value of 92.5IU/L. CK-18 detected fibrosis with 92.3% sensitivity and 71.1% specificity.
Conclusion: CK-18 can be used as a non-invasive predictor of activity and fibrosis.