Zhang HY, Zhang RL, Jia YY, Liu Y, Zhu L, Liu F, Rao HY. Diagnostic value of serum chitinase-3-like protein 1 for liver fibrosis/cirrhosis and hepatocellular carcinoma. World J Gastrointest Oncol 2026; 18(4): 116821 [DOI: 10.4251/wjgo.v18.i4.116821]
Corresponding Author of This Article
Hui-Ying Rao, MD, Professor, Peking University People's Hospital, Peking University Hepatology Institute, Infectious Disease and Hepatology Center of Peking University People's Hospital, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on Non-alcoholic Fatty Liver Disease Diagnosis, No. 133 Fuchengmennei Street, Xicheng District, Beijing 100044, China. rao.huiying@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
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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/
Apr 15, 2026 (publication date) through Apr 11, 2026
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Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Oncology
ISSN
1948-5204
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Zhang HY, Zhang RL, Jia YY, Liu Y, Zhu L, Liu F, Rao HY. Diagnostic value of serum chitinase-3-like protein 1 for liver fibrosis/cirrhosis and hepatocellular carcinoma. World J Gastrointest Oncol 2026; 18(4): 116821 [DOI: 10.4251/wjgo.v18.i4.116821]
Hai-Ying Zhang, Run-Ling Zhang, Yu-Yuan Jia, Yan Liu, Ling Zhu, Feng Liu, Hui-Ying Rao, Peking University People's Hospital, Peking University Hepatology Institute, Infectious Disease and Hepatology Center of Peking University People's Hospital, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on Non-alcoholic Fatty Liver Disease Diagnosis, Beijing 100044, China
Co-first authors: Hai-Ying Zhang and Run-Ling Zhang.
Author contributions: Zhang HY and Zhang RL contribute equally to this study as co-first authors; Zhang HY and Zhang RL designed the experiments, completed the manuscript writing and conducted the collation and statistical analysis; Jia YY, Liu Y and Zhu L conducted clinical data collection and recorded the data; Liu F and Rao HY make critical revisions to important knowledge content; all authors have read and approve the final manuscript.
Supported by National Key Research and Development Program of China, No. 2022YFA1303804.
Institutional review board statement: The study was reviewed and approved by the Ethical Review Committee of Peking University People's Hospital (Approval No. 2025PHB541-001).
Informed consent statement: This study does not require the signing of an informed consent form, as it employs de-identified data for analysis and adheres to the principles of the Declaration of Helsinki. The ethics committee of the institution agreed to waive informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Corresponding author: Hui-Ying Rao, MD, Professor, Peking University People's Hospital, Peking University Hepatology Institute, Infectious Disease and Hepatology Center of Peking University People's Hospital, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on Non-alcoholic Fatty Liver Disease Diagnosis, No. 133 Fuchengmennei Street, Xicheng District, Beijing 100044, China. rao.huiying@163.com
Received: November 21, 2025 Revised: January 4, 2026 Accepted: January 12, 2026 Published online: April 15, 2026 Processing time: 138 Days and 16.5 Hours
Abstract
BACKGROUND
The diagnostic value of serum chitinase-3-like protein 1 (CHI3L1) in liver fibrosis and cirrhosis, as well as its prognostic significance in hepatocellular carcinoma (HCC), remains incompletely understood.
AIM
To assess the diagnostic value of CHI3L1 for liver cirrhosis in liver disease patients and its prognostic significance in HCC.
METHODS
A retrospective study was conducted at a tertiary hospital to measure serum CHI3L1 levels in 551 patients from different cohorts (viral/non-viral hepatitis, cirrhosis, HCC, post-radical hepatectomy HCC, and HCC recurrence) and healthy controls using electrochemiluminescence. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of CHI3L1, and its correlation with liver stiffness measurement (LSM) and the fibrosis-4 index (FIB-4) was analyzed.
RESULTS
Serum CHI3L1 levels were significantly higher in the cirrhosis, HCC, post-radical hepatectomy HCC, and HCC recurrence groups than in the control group (all P < 0.05). The cirrhosis group had higher serum CHI3L1 levels than the viral hepatitis and non-viral hepatitis groups (both P < 0.01), and the HCC group had higher serum CHI3L1 levels than the post-radical hepatectomy HCC group (P < 0.001). The areas under the ROC curve of CHI3L1 for diagnosing cirrhosis, HCC, and HCC recurrence were 0.874, 0.858, and 0.723, respectively. CHI3L1 levels were positively correlated with LSM (r = 0.424, P < 0.001) and FIB-4 (r = 0.370, P < 0.001). CHI3L1 levels differed significantly between fibrosis grades F3 and F4 (P < 0.01).
CONCLUSION
Serum CHI3L1 levels hold significant diagnostic value for liver fibrosis, cirrhosis, and HCC, serving as an effective non-invasive marker for these conditions as well as HCC recurrence.
Core Tip: Serum chitinase-3-like protein 1 (CHI3L1) demonstrates robust diagnostic performance for liver cirrhosis [area under the receiver operating characteristic curve (AUC) = 0.874], hepatocellular carcinoma (HCC; AUC = 0.858) and HCC recurrence (AUC = 0.723) in liver disease patient cohorts. CHI3L1 exhibits positive correlations with liver stiffness measurement and the fibrosis-4 index, effectively differentiates fibrosis grades F3 and F4, and emerged as a reliable non-invasive biomarker for liver disease stratification, treatment monitoring and prognosis prediction, with superior performance than single traditional indices.
