Diagnostic Role of Serum Golgi Protein 73 as a Biomarker for the Assessment of Significant Hepatic Fibrosis in Patients with Chronic Hepatitis B Infection

Abstract

epatitis B virus -related fibrosis or cirrhosis is a progressive disease, ultimately resulting in end-stage liver disease or hepatocellular carcinoma (HCC). Therefore, the detection and quantification of liver fibrosis is a key factor for disease management and prognostication for an individual with HBV. Liver biopsy has been the “gold standard” for liver fibrosis staging for decades. However, liver biopsy is a costly and invasive procedure. Therefore, the growing need for alternative approache to the assessment of liver disease severity has driven the development of several non-invasive methods in order to overcome the limitations of liver biopsy. The application of these techniques in the setting of hepatitis B viral disease for both assessment of liver fibrosis and prediction of liver-related complications can lead to improvement in terms of patient treatment. Both blood- and imaging-based approaches have advantages over liver biopsy, including minimal risks, lower cost, better patient acceptance and speed of results, while disadvantages include lower diagnostic accuracy in intermediate disease stages and variability with co-existing hepatic inflammation or steatosis. This study was applied on 40 antiviral-naïve HBV patients; recruitment was done in viral hepatitis unit outpatient clinic, Faculty of Medicine Ain shams university research institute in the period between August 2020 and March 2021. All enrolled patients had undergone through clinical examination, assessment of biochemical parameters, abdominal ultrasound and assessment of hepatic fibrosis using noninvasive serological biomarkers (Fib-4 and APRI) and serum Golgi protein 73. Patients were subdivided into two groups according to their fibrosis stage as assessed by non-invasive indirect serum biomarkers (FIB-4 index and APRI score); 29 patients (72.5%) had no or Mild liver fibrosis (<F2) and 11patients (27.5%) had significant fibrosis (≥ F2). The age of the patients range from 18 to 65 years with mean of 43.78, there was male predominance with male to female ratio about 1.9:1. Our study showed Statistically significant correlation between APRI score and FIB-4 Index with age of the patients, haemoglobin level, Platelets, albumin, AST level, ALT level, INR and Direct bilirubin levels with p value <0.001 for the age, AST, ALT, Platelets and Albumin, with p value <0.015 for haemoglobin and Direct bilirubin and with p value <0.005 for INR By using Pearson Correlation Coefficient. Serum biomarker GP 73 showed statistically significant correlation with Age in years (P <0.005), AST level (P <0.017), ALT level (P <0.022) and Platelets (P <0.002) and statistically insignificant correlation with Haemoglobin, albumin level, INR, and direct bilirubin level.