The informative value of assessment of direct serum biomarkers for diagnosis of various stages of liver fibrosis in children

Introduction. Serum concentrations of collagens I, III, IV types (K-I, K-III, K-IV) and hyaluronic acid (HA) are reported to be informative in terms of noninvasive diagnosis liver fibrosis stages. In pediatrics, there is not enough data on this. Purpose was to assess the diagnostic value of direct biomarkers in predicting the stage of fibrosis in children with chronic liver diseases (CLD).

Materials and methods. A prospective single-center study included 80 children with CLD . All patients underwent marginal resection of liver tissue under laparoscopic control. The serum  K-I, K-IV, and HA concentration were measured by enzyme immunoassay. The authors applied ROC curve analysis to assess quantitative signs’ diagnostic significance in predicting a specific outcome.

Results.The optimal KI value for the diagnosis of cirrhosis was 144.24 ng/ml, with AUROC: 0.758 ± 0.101 with 95% CI: 0.560–0.957, sensitivity and specificity 65.2% and 77.8%, respectively. The optimal K-IV values for the diagnosis of moderate fibrosis and cirrhosis were 11.29 ng/ml and 27.40 ng/ml, respectively, with AUROC 0.807 ± 0.092 with 95% CI: 0.627–0.987, 0.685 ± 0.062 with 95% CI: 0.567–0.810, sensitivity 82.4% and 61.15%, specificity 66.7%, and 64.7%, respectively. The optimal BG values for the diagnosis of weak and moderate fibrosis were 34.9 ng/ml and 36.5 ng/ml, for cirrhosis 38.3 ng/ml, with AUROC 0.912 ± 0.050 with 95% CI: 0.815–1.00; 0.849 ± 0.064 with 95% CI: 0.723–0.974, and 0.825 ± 0.048 with 95% CI: 0.730–0.920, respectively. Sensitivity was 84.6% at all stages, specificity — 77.8%, 61.5% and 70.6%, respectively.

Conclusions. LF biomarkers have diagnostic significance in the detection of the stages of liver fibrosis. LF biomarkers are informative, reproducible noninvasive indices in the diagnosis of liver fibrosis in children.

Contribution:
Kulebina E.A., Surkov A.N., Potapov A.S. — research concept and design;
Kulebina E.A., Surkov A.N. — collection and processing of material;
Kulebina E.A., Surkov A.N. — statistical processing;
Kulebina E.A., Surkov A.N., Alyabeva N.M., Zubkova I.V., Zhuzhula A.A. — text writing;
Fisenko A.P., Potapov A.S. — editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Informed consent: a written, voluntary, informed consent to participate in the study was obtained from the parents
of the patients.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: February 18, 2021
Accepted: February 22, 2021
Published: March 10, 2021

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