Published online Jan 7, 2020. doi: 10.3748/wjg.v26.i1.97
Peer-review started: October 31, 2019
First decision: November 22, 2019
Revised: December 4, 2019
Accepted: December 14, 2019
Article in press: December 14, 2019
Published online: January 7, 2020
Processing time: 67 Days and 21.5 Hours
Developments of serum biomarkers have focused on the diagnosis of cirrhosis, but more recent researches have emphasized the availability of these markers to assess patients with more advanced fibrosis.
The autotaxin (ATX) level may be a useful biomarker to select treatment therapy for ascites, hepatic encephalopathy, and varix ruptures. And the assessment for the complications of liver cirrhosis (LC) is especially valuable in helping to make treatment decisions.
The aim of this study was to assess the clinical usefulness of ATX for assessing the complications of LC.
This multicenter, retrospective study was conducted at six locations in Japan. We include patients with LC, n = 400. The ATX level was evaluated separately in men and women because of its high level in female patients. To assess the clinical usefulness of ATX for the complications of LC, the area under the curve (AUC) of ATX assessing for the severe complications was analyzed in comparison with the model for end-stage liver disease score, albumin-bilirubin (ALBI) score, fibrosis-4 index, and aspartate aminotransferase-to-platelet ratio index.
The AUCs of ATX in men for hepatic encephalopathy, hepatic ascites, and varix ruptures were 0.853, 0.816, and 0.706, respectively. The AUCs of ATX in women for hepatic encephalopathy, hepatic ascites, and varix rupture were 0.759, 0.717, and 0.697, respectively. The AUCs of ATX in men were higher than those in women, as were all the other biomarkers used to detect encephalopathy and varix ruptures. However, for detecting ascites, the AUC of ALBI in men was more effective than using ATX.
ATX is a useful biomarker for assessing the complications of LC. Especially, the use of ATX in men was more effective than any other biomarker for detecting hepatic encephalopathy and varix ruptures. The ATX level is especially valuable in helping to make treatment decisions for hepatic encephalopathy and varix ruptures. ATX in men was more effective than any other biomarkers for detecting hepatic encephalopathy and varix ruptures. Developments of serum biomarkers have focused on the diagnosis of cirrhosis and the assessment of advanced fibrosis. Using ATX as a biomarker in men was more efficacious than that of any other biomarkers for hepatic encephalopathy and varix ruptures. To make treatment decisions, it is necessary to consider that patients with high ATX levels may have complications of LC. ATX is a useful clinical biomarker for assessing the complications of LC because it could reflect not only hepatic fibrosis but also hepatic function. Direct biomarkers reflect not only hepatic fibrosis but also hepatic function. The gold standard for assessment of the severity of portal hypertension is the hepatic venous pressure gradient (HVPG). Future studies on the HVPG may make it the first-choice biomarker for the assessment of portal hypertension.
Direct biomarkers reflect not only hepatic fibrosis but also hepatic function. The gold standard for assessment of the severity of portal hypertension is the HVPG. Future studies on the HVPG may make it the first-choice biomarker for the assessment of portal hypertension. The best method is a direct comparison of the ATX and HVPG for assessing the complications of LC.