Prognostic role of the stromal cell derived factor-1 in patients with hepatitis B virus-related acute-on-chronic liver failure

Figure 1 Immunohistochemical staining for stromal cell derived factor-1 in livers. Stromal cell derived factor-1 (SDF-1) distribution was extended to bile ductule and hepatic progenitor cells. A: Strongly positive immunostaining in hepatitis B virus-related acute-on-chronic liver failure (ACLF) patients; B: Moderately positive immunostaining in chronic hepatitis B patients; C: Weakly positive immunostaining in healthy controls; D: Comparison of the SDF-1 average absorbance between ACLF group and other groups. A-C: 200 ×. SDF-1: Stromal cell derived factor-1; ACLF: Acute-on-chronic liver failure; CHB: Chronic hepatitis B.

Figure 2 Immunohistochemical staining for CXCR4 in livers. CXCR4 staining was observed predominantly in the membrane and cytoplasm of bile duct epithelium and hepatic progenitor cells. A: Strongly positive immunostaining in hepatitis B virus-related acute-on-chronic liver failure (ACLF) patients; B: Weakly positive immunostaining in chronic hepatitis B patients; C: Negative immunostaining in healthy controls; D: Comparison of the CXCR4 average absorbance between ACLF group and other groups. A-C: 400 ×. CXCR4: CXC receptor 4; ACLF: Acute-on-chronic liver failure; CHB: Chronic hepatitis B.

Figure 3 Immunohistochemical staining for Ki67+ cells in livers. The distribution of Ki67 was predominantly in the portal areas, and minorly in the liver parenchyma. A: Strongly positive immunostaining in hepatitis B virus-related acute-on-chronic liver failure (ACLF) patients; B: Moderately positive immunostaining in chronic hepatitis B patients; C: Weakly positive immunostaining in healthy controls; D: Comparison of the amounts of Ki67+ cells between ACLF group and other groups. A-C: 200 ×. ACLF: Acute-on-chronic liver failure; CHB: Chronic hepatitis B.

Figure 4 Increased serum stromal cell derived factor-1 predicted poor prognosis in hepatitis B virus-related acute-on-chronic liver failure patients. Linear correlation of serum stromal cell derived factor-1 (SDF-1) levels with disease severity marker in acute-on-chronic liver failure (ACLF) patients. SDF-1 was positively correlated with A: Total bilirubin; B: International normalized ratio; C: Non-survivors (n = 19) had elevated SDF-1 levels compared with survivors (n = 11) of patients with hepatitis B virus (HBV)-related ACLF; D: Showed the area under the curve (AUC) of the serum SDF-1 level in predicting 28-d mortality of HBV-related ACLF patients. The AUC was 0.722 (95%CI 0.526-0.919). SDF-1: Stromal cell derived factor-1; TBIL: Total bilirubin; INR: International normalized ratio.