Abstract
Serum Golgi protein 73 (GP73) is a promising marker for significant fibrosis in adults. However, current diagnostic value of serum GP73 for liver fibrosis in children is unknown. To investigate the relationship between levels of serum GP73 and liver fibrosis in children, we measured serum GP73 in 86 healthy controls and 183 patients with liver diseases using commercially available double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) kit. The value of serum GP73 in fibrosis stage assessment was compared with aspartate transaminase to platelet ratio index (APRI). We found that serum GP73 was decreasing with age in healthy controls, while it was increasing with the extent of inflammation and fibrosis in patients with liver diseases. Though area under the receiver operating curve (AUROC) of serum GP73 for diagnosing significant fibrosis was nearly equal to APRI (0.62 vs 0.64) in patients aged 3 years or older, AUROC for serum GP73 was superior to APRI (0.76 vs 0.67) in patients aged below 3 years, indicating that serum GP73 is comparable to APRI for diagnosing significant fibrosis in children.
Highlights
Chronic liver diseases, including genetic diseases, viral hepatitis, autoimmune hepatitis, and congenital malformations can lead to liver fibrosis and eventually to cirrhosis in children
We noticed that the level of serum Golgi protein 73 (GP73) in subgroup aged less than three years was significantly higher than that of in subgroup aged three years or older (172.9 ± 84 vs 56.3 ± 23.4, P < 0.001)
Its expression is significantly increased in advanced liver diseases, especially in hepatic cirrhosis[15,18,19]
Summary
Chronic liver diseases, including genetic diseases, viral hepatitis, autoimmune hepatitis, and congenital malformations can lead to liver fibrosis and eventually to cirrhosis in children. Precise assessment of liver fibrosis is crucial for prognosis and long-term monitoring in children. Liver biopsy has long been considered a gold diagnostic standard for assessing liver fibrosis, but it is difficult to implement in children because of its limitations such as invasiveness, non-repeatability, complication, and sampling errors[6,7]. Serum GP73 has been widely used for diagnosing hepatocelluar carcinoma (HCC) and monitoring progression of liver diseases in adults[8,9,10,11,12]. Several studies showed that GP73 might be a potential marker for diagnosing significant fibrosis and cirrhosis in adults[14,15,16]. The present study was designed to explore the value of serum GP73 levels in diagnosing significant fibrosis in children
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