Predictive value of cytokeratin-18 fragment levels for diagnosing steatohepatitis in patients with nonalcoholic fatty liver disease. Issue 11 (November 2021)

• Record Type: Journal Article
• Authors: Tada, Toshifumi; Saibara, Toshiji; Ono, Masafumi; Takahashi, Hirokazu; Eguchi, Yuichiro; Hyogo, Hideyuki; Kawanaka, Miwa; Kumada, Takashi; Toyoda, Hidenori; Yasuda, Satoshi; Nakajima, Atsushi; Yoneda, Masato; Tanaka, Saiyu; Shimada, Keiji; Hoshino, Hideaki; Aishima, Shinichi; Kage, Masayoshi; Sumida, Yoshio
• Is Part Of: European journal of gastroenterology & hepatology. Volume 33:Issue 11(2021)
• Publication Date: 2021-11
• Subjects: cytokeratin-18 fragment -- FIB-4 index -- nonalcoholic fatty liver -- nonalcoholic steatohepatitis; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Digestive organs -- Diseases; Liver -- Diseases; Periodicals; 616.33
• DOI: 10.1097/MEG.0000000000002176
• Languages: English
• ISSNs: 0954-691X

Abstract

Abstract : Objective: Several noninvasive markers have been developed to predict nonalcoholic steatohepatitis (NASH). We investigated the predictive value of the cytokeratin-18 fragment (CK18-F) level and FIB-4 index for diagnosing NASH in patients with nonalcoholic fatty liver disease (NAFLD). Methods: A total of 246 patients histologically diagnosed with NASH ( n = 185) or nonalcoholic fatty liver ( n = 61) were enrolled. We analyzed weighted receiver operating characteristic (ROC) curves for the prediction of NASH and determined the relationship between the CK18-F level and the histological features of NASH. In addition, we investigated the predictive value of the combination of the CK18-F level and FIB-4 index for diagnosing NASH. Results: The area under the ROC curve (AUROC) value of the CK18-F level was 0.77. With a CK18-F cutoff level of 260 U/L, the sensitivity and specificity for diagnosing NASH were 82.7 and 57.4%, respectively. Multiple comparisons showed that the CK18-F level did not differ among fibrosis stages but did significantly differ among hepatocyte ballooning grades. Overall, 95.7% (66/69) of patients with a FIB-4 index of ≥2.67 had NASH. In patients with a FIB-4 index of <2.67, the AUROC value of the CK18-F level for predicting NASH was 0.77 and a CK18-F cutoff level of 260 U/L resulted in a sensitivity and specificity of 82.4 and 56.9%. Conclusions: The CK18-F level had a good predictive ability for diagnosing NASH in patients with NAFLD. Additionally, the combination of the CK18-F level and FIB-4 index accurately and noninvasively predicted NASH, even those with a low FIB-4 index. Abstract : Supplemental Digital Content is available in the text.