| Background and Aim: HBV infection remains a main etiological factor of chronic hepatitis and a significant global public health issue. An estimated 350 million persons are chronically infected with HBV globally. The chronic hepatitis patients have a high risk of progression to cirrhosis and hepatocellular carcinoma via liver fibrosis and liver fibrosis in early and middle stages could reverse by clinical intervention, so early diagnosis of liver fibrosis is essential for patients’ prognosis. The diagnostic of liver fibrosis is usually by liver biopsy, imaging examination and clinical symptoms. However, the serum biomarker which has high sensitivity and specificity for diagnosis of liver fibrosis is absent currently. Autoantibody is a new type of serum biomarker discovered in recent years, which elicited by the abnormal protein, a so called autoantigen. As immunodiagnostic markers, the autoantibodies may have various advantages since the magnified signals of the autoantibodies can be easier to detect than autoantigen themselves, so the autoantibodies have higher sensitivity and may be act as biomarkers for the early stage of diseases. Unlike the autoantibodies in autoimmune diseases, these autoantibodies have been reported in a wide variety of tumors. A recent study also showed that the autoantibody against alpha-enolase(ENO1) has potential diagnostic value for liver fibrosis. The aim of this study was to study for the clinical value of several serum autoantibody biomarkers for discrimination of the liver fibrosis at different stages by protein chip technology.Method: 250 cases HBV related liver fibrosis at different stages were enrolled in our study, and the cases of S01, S23 and S4 patients were 73, 126 and 51 respectively. All of them were evaluated by China S2000. 100 cases of healthy people were act as control. We prepared protein chips containing eight autoantigens screened by our previous study to detect the level of serum autoantibodies. Receiver-operating characteristic curve(ROC) was used to analyse the best diagnostic cutoff value of the autoantibodies and their sensitivity and specificity. The average level of autoantibody at different stages of liver fibrosis was compared by T-test, and the prevalence of autoantibody positivity was analyzed using the chi-squared(χ2) test with Yate’s correction, and using χ2 test to analyze the correlations between autoantibody positivity and demographic parameters such as age, sex and the biochemical imdex of hepatic function.Result: For the eight autoantigens evaluation, the level of Centromere protein F(CENPF) autoantibody rising along with the prodression of liver fibrosis, patients at S01/S4 and S23/S4 stages showed significant difference for signal intensity(P<0.05), but S01 and S23 did not show statistical difference, with the area under ROC curve(AUC) value of 0.648, 0.641 and 0.505, and their sensitivity and specificity were 54.9%/74.0%, 54.9%/74.0% and 85.9%/24.7% respectively. Some other autoantibodies also showed several statistical differences between different stages of liver fibrosis. χ2 test did not show significant differences among autoantibody positivity and demographic parameters. The AUC values of cmbined CENPF and Amino Acylase-1(ACY1) for discrimination of S01/S4 and S23/S4 were 0.692 and 0.698 respectively.Conclution: The serum autoantibody biomarkers may have certain value in discriminating liver fibrosis at different stages and deserve further study. |
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