Cheng JL, Wang XL, Yang SG, Zhao H, Wu JJ, Li LJ. Non-ALT biomarkers for markedly abnormal liver histology among Chinese persistently normal alanine aminotransferase-chronic hepatitis B patients. World J Gastroenterol 2017; 23(15): 2802-2810 [PMID: 28487618 DOI: 10.3748/wjg.v23.i15.2802]
Corresponding Author of This Article
Lan-Juan Li, MD, State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Centre for the Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China. ljli@zju.edu.cn
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Cheng JL, Wang XL, Yang SG, Zhao H, Wu JJ, Li LJ. Non-ALT biomarkers for markedly abnormal liver histology among Chinese persistently normal alanine aminotransferase-chronic hepatitis B patients. World J Gastroenterol 2017; 23(15): 2802-2810 [PMID: 28487618 DOI: 10.3748/wjg.v23.i15.2802]
World J Gastroenterol. Apr 21, 2017; 23(15): 2802-2810 Published online Apr 21, 2017. doi: 10.3748/wjg.v23.i15.2802
Non-ALT biomarkers for markedly abnormal liver histology among Chinese persistently normal alanine aminotransferase-chronic hepatitis B patients
Jin-Lin Cheng, Xiao-Ling Wang, Shi-Gui Yang, Hong Zhao, Jing-Jing Wu, Lan-Juan Li
Jin-Lin Cheng, Shi-Gui Yang, Jing-Jing Wu, Lan-Juan Li, State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Centre for the Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Xiao-Ling Wang, Department of Pathology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Hong Zhao, Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Cheng JL designed and wrote the paper; Wang XL performed the pathological diagnosis work; Yang SG analyzed the data; Zhao H performed the research; Wu JJ collected the data and pathological sections; Li LJ supervised the study.
Supported bythe National Science and Technology Major Project of China, No. 2012ZX10002004-001.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the First Affiliated Hospital, School of Medicine, Zhejiang University.
Informed consent statement: Informed consent was obtained from the patients.
Conflict-of-interest statement: No commercial or associative interest in any form has been received or will be received from a commercial party related directly or indirectly to the subject of this paper.
Data sharing statement: Technical appendix, statistical code, and dataset are available from the corresponding author at ljli@zju.edu.cn.
Correspondence to: Lan-Juan Li, MD, State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Centre for the Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China. ljli@zju.edu.cn
Telephone: +86-571-87236758 Fax: +86-571-87236759
Received: November 11, 2016 Peer-review started: November 12, 2016 First decision: December 29, 2016 Revised: January 12, 2017 Accepted: February 17, 2017 Article in press: February 17, 2017 Published online: April 21, 2017 Processing time: 159 Days and 21.3 Hours
Abstract
AIM
To determine incidence and clinical biomarkers of marked necroinflammation and fibrosis characteristics among chronic hepatitis B (CHB) patients with persistently normal alanine aminotransferase (PNALT).
METHODS
Liver biopsy was performed on 115 CHB patients with PNALT. Necroinflammation and fibrosis were graded by the Knodell histologic activity index and the Ishak fibrosis score, respectively. Correlations between the available clinical parameters and necroinflammation and fibrosis were analysed.
RESULTS
Marked necroinflammation (Knodell activity index ≥ 7) and fibrosis (Ishak fibrosis score ≥ 3) were found in 36.5% and 15.5% of CHB patients with PNALT, respectively. Following a univariate logistic regression analysis, multiple logistic regression analysis indicated that aspartate transaminase (AST) (AUROC = 0.852, cut-off value = 22.5 U/L) serves as an independent predictor of notable liver inflammation, while platelet (PLT) count (AUROC = 0.905, cut-off value = 171.5 ×109/mL) and gamma-glutamyl transpeptidase (GGT) (AUROC = 0.909, cut-off value = 21.5 U/L) level serve as independent predictors of notable liver fibrosis.
CONCLUSION
A considerable proportion of marked histological abnormalities existed in our cohort, who will benefit from optimal therapeutic strategies administered according to predictive indication by AST, PLT and GGT levels.
Core tip: Marked necroinflammation and fibrosis were present in the livers of chronic hepatitis B virus-infected Chinese patients with persistently normal alanine aminotransferase. Clinical parameters associated with liver injury were identified. The identified biomarkers can indicate patients with liver injury.
