细胞角蛋白18片段在肝脏炎症和纤维化中的作用：系统回顾和荟萃分析。

IF 3.2 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinica Chimica Acta Pub Date : 2025-01-19 DOI:10.1016/j.cca.2025.120147

Junzhao Ye , Jiaming Lai , Ling Luo , Ting Zhou , Yanhong Sun , Bihui Zhong

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引用次数: 0

摘要

背景：本荟萃分析旨在总结细胞角蛋白（CK） 18测量值的诊断准确性和临界值，特别是M30和M65，作为用于慢性肝病患者肝脏炎症和纤维化分期的活检标本病理评估的候选生物标志物。方法：检索截至2025年1月11日的文献。在不考虑异质性的情况下，使用随机效应模型计算合并敏感性、特异性、受试者工作特征曲线下面积和平均截止值。采用meta回归分析和亚组分析探讨异质性。结果：纳入63项研究，9137例患者。根据METAVIR评分系统，CK18 M30诊断肝脏明显炎症、纤维化≥F1、≥F2、≥F3、=F4的AUROC曲线汇总为0.82、0.75、0.78、0.78、0.76，平均临界值分别为264.3、188.0、276.9、322.8、169.4 U/L。M65检测肝脏明显炎症、纤维化≥F1、≥F2、=F4的AUROC曲线总结值分别为0.79、0.70、0.76、0.64、0.72，平均截断值分别为541.1、417.6、500.1、424.6、674.0 U/L。亚组分析表明，当用于检测显著炎症时，种族可能是与ck18m30异质性相关的主要因素。亚裔患者比非亚裔患者高79.7 U/L （p = 0.0157）。结论：CK18 M30和M65作为脂肪肝或病毒性肝炎患者活检标本确定肝脏炎症和纤维化的替代诊断工具具有临床意义的准确性。注册：普洛斯彼罗注册号：CRD42022364598。

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Cytokeratin 18 fragment in liver inflammation and fibrosis: Systematic review and meta-analysis

Background

This meta-analysis aimed to summarize the diagnostic accuracy and cut-off values of cytokeratin (CK) 18 measurements, specifically M30 and M65, as candidate biomarkers for the pathological evaluation of biopsy specimens used to stage liver inflammation and fibrosis in patients with chronic liver diseases.

Methods

Databases were searched for studies collected up to January 11th, 2025. Pooled sensitivity, specificity, area under the receiver-operating characteristic curves, and mean cut-off values were calculated using random-effects models regardless of heterogeneity. A meta-regression analysis and subgroup analysis were performed to explore heterogeneity.

Results

Sixty-three studies comprising 9137 patients were included. The summarized AUROC curve of CK18 M30 for the diagnosis of significant liver inflammation, fibrosis ≥F1, ≥F2, ≥F3, and =F4 according to the METAVIR score system were 0.82, 0.75, 0.78, 0.78 and 0.76, with mean cut-off values of 264.3, 188.0, 276.9, 322.8 and 169.4 U/L. For M65, the summarized AUROC curve for detecting significant liver inflammation, fibrosis ≥F1, ≥F2, and =F4 were 0.79, 0.70, 0.76, 0.64 and 0.72, with mean cut-off values of 541.1, 417.6, 500.1, 424.6 and 674.0 U/L. The subgroup analyses implied that ethnicity may be the primary factor related to heterogeneity in CK18 M30 when applied to detect significant inflammation. Asian patients had values 79.7 U/L higher than those of non-Asian patients (p = 0.0157).

Conclusions

CK18 M30 and M65 have clinically meaningful accuracy as alternative diagnostic tools for determining liver inflammation and fibrosis using biopsy specimens of patients with steatotic liver disease or viral hepatitis.

Registration: PROSPERO registration number: CRD42022364598.

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来源期刊

Clinica Chimica Acta 医学-医学实验技术

CiteScore

10.10

自引率

2.00%

发文量

1268

审稿时长

23 days

期刊介绍： The Official Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Clinica Chimica Acta is a high-quality journal which publishes original Research Communications in the field of clinical chemistry and laboratory medicine, defined as the diagnostic application of chemistry, biochemistry, immunochemistry, biochemical aspects of hematology, toxicology, and molecular biology to the study of human disease in body fluids and cells. The objective of the journal is to publish novel information leading to a better understanding of biological mechanisms of human diseases, their prevention, diagnosis, and patient management. Reports of an applied clinical character are also welcome. Papers concerned with normal metabolic processes or with constituents of normal cells or body fluids, such as reports of experimental or clinical studies in animals, are only considered when they are clearly and directly relevant to human disease. Evaluation of commercial products have a low priority for publication, unless they are novel or represent a technological breakthrough. Studies dealing with effects of drugs and natural products and studies dealing with the redox status in various diseases are not within the journal''s scope. Development and evaluation of novel analytical methodologies where applicable to diagnostic clinical chemistry and laboratory medicine, including point-of-care testing, and topics on laboratory management and informatics will also be considered. Studies focused on emerging diagnostic technologies and (big) data analysis procedures including digitalization, mobile Health, and artificial Intelligence applied to Laboratory Medicine are also of interest.