Investigation Of The Relationship Beteewn The Serum Levels Of Macrophage Colony Stimulating Factor (M-CSF) And Chronic Hepatitis B Virus Infection With Liver Fibrosis Progression

Objective To research M-CSF level in the patients,serum with chronic hepatitis B virus infection of the different degree of liver fibrosis progression and its non-invasive diagnosis value.And to explore whether it can be the therapeutic target of anti-hepatic fibrosis.Methods Assess the hepatic fibrosis degree of 175 chronic hepatitis B infection patients by liver biopsy and collect peripheral blood of all the patients on the day of the puncture operation.Centrifuge the collected peripheral blood to obtain serum.The expression level of M-CSF in serum of 19 healthy people and 175 patients was measured by ELISA method.And other routine laboratory indicators are detected by ELISA method to calculate APRI and FIB-4 index.The coresponding liver stiffness values(LSM)of 175 patients were detected by Fibrotouch.First,the correlations between the serum M-CSF level and other serological indicators(including transaminase and virus detection)which reflect the inflammation and injury in liver were analyzed in order to find out the relationship between M-CSF and inflammation.The value in diagnosis of M-CSF,APRI,FIB-4 index and LSM in predicting whether the liver fibrosis and early cirrhosis occur were evaluated by the area under the receiver operating characteristic curves,the specificity and sensitivity.Results The serum M-CSF level was significantly positively correlated with AST,ALP and GGT(the correlation coefficients were 0.169,0.167 and 0.151,P<0.05),and there was a significant negative correlation between M-CSF with ALB(the correlation coefficient was-0.234,P=0.002<0.05).There was significant difference of serum M-CSF level between patients with HBV DNA>2000IU/ml and patients with HBV DNA<2000IU/ml(P=0.005<0.05).The serum level of M-CSF among no fibrosis group(S0 and healthy subject),mild fibrosis group(S1-S2),moderate and severe fibrosis group(S3-S4)was statistically significantly different(P=0.000<0.05)and it was also significantly different in various inflammation group(P=0.000<0.05).The area under ROC curve(AUC)of M-CSF for liver fibrosis occuring(S≧1)were 0.827,the sensitivity and specificity were 74.4% and 80.0% respectively.The AUC of M-CSF for early cirrhosis(S4)were0.627,the sensitivity and specificity were 59.7% and 73.0%.Conclusion The serum level of M-CSF in patient with different degree of fibrosis after chronic HBV infection were remarkably different.The patients with severe liver fibrosis always have higher levels of serum M-CSF than the patients with mild liver fibrosis.The serum M-CSF level could have a certain value for predicting the degree of liver fibrosis and it has the potential to be a new direction for exploration about the therapeutic target of anti-hepatic fibrosis.