During the 2024 Annual Meeting of the American Association for the Study of Liver Diseases (AASLD), a research team led by Dr. Jie Li from Nanjing Drum Tower Hospital, Nanjing University Medical School, and Dr. LiZhu from Suzhou Fifth People’s Hospital, presented groundbreaking findings on the non-invasive diagnosis of liver fibrosis in chronic hepatitis B (CHB) using a combination of PRO-C3 and GP73 biomarkers. This innovative study received the "Poster of Distinction" award at the conference, and we are pleased to share its key insights with our readers.Liver fibrosis is a crucial determinant for initiating antiviral therapy in chronic hepatitis B (CHB) patients. PRO-C3, a biomarker reflecting liver fibrosis extent, and GP73, a glycoprotein overexpressed in liver disease, have shown potential in diagnosing CHB-related fibrosis, but data on their performance in large populations are limited. This study assessed the diagnostic value of PRO-C3, GP73, and their combination compared to other non-invasive tests (NITs) using liver histology as the gold standard.
The study enrolled 324 treatment-naïve CHB patients who underwent liver biopsies and serum tests. Fibrosis stages were assessed using the Scheuer scoring system. Serum levels of PRO-C3 and GP73 were measured using ELISA. The diagnostic performance of PRO-C3, GP73, their combination, and other NITs was evaluated using statistical methods.
Results showed that PRO-C3 and GP73 levels were significantly higher in patients with significant (S2-4) or advanced (S3-4) fibrosis. Both biomarkers were independent predictors of significant and advanced fibrosis, even after adjusting for confounding factors. The area under the ROC curve (AUC) for PRO-C3 and GP73 in diagnosing significant fibrosis was 0.81 and 0.75, respectively, and 0.80 and 0.73 for advanced fibrosis. Combining PRO-C3 and GP73 yielded an AUC of 0.84 for significant fibrosis, outperforming other NITs. In diagnosing advanced fibrosis, the PRO-C3 and PRO-C3+GP73 models were superior to FIB-4 and comparable to other NITs.
Calibration curves and decision curve analysis further confirmed the superiority of the PRO-C3+GP73 model in diagnosing significant and advanced fibrosis. The combination provided the highest clinical net benefit for predicting significant fibrosis.
In conclusion, PRO-C3, particularly when combined with GP73, is a reliable non-invasive biomarker for diagnosing liver fibrosis in CHB patients. It offers superior diagnostic accuracy compared to other NITs, making it a cost-effective and precise alternative for monitoring fibrosis progression and guiding clinical decisions in CHB management.
