ABSTRACT
Objective@#To study the correlation between the level of serum Chitinase-3-like protein 1 (CHI3L1) and the significant liver fibrosis and liver cirrhosis in patients with chronic liver disease, and to evaluate its diagnostic value. @*Methods@#165 patients with chronic liver disease were selected, liver histopathological examination was performed to detect serum CHI3L1 concentration. Four indexes of hepatic fibrosis (type III procollagen, collagen IV, laminin, hyaluronic acid), aspartate aminotransferase/platelet ratio index (APRI) and FIB-4 (fibrosis- 4) scores were based on the pathological findings of liver biopsy and compared the advantages and disadvantages of serum CHI3L1 with other methods for the diagnosis of hepatic fibrosis and liver cirrhosis. A multivariate regression analysis model was created, and receiver operating characteristic curve was analyzed. @*Results@#The level of serum CHI3L1 increased with increase of fibrosis stage and was highest in liver cirrhosis stage. In the period of S0 to 1, the levels of S2 to 3 and S4 were 62.82 (41.40 ~ 87.20), 70.94 (48.47 to 122.60) and 141.06 (78.18 ~ 197.40), and there were statistically significant differences between the groups (P < 0.001). The area under the curve for the diagnosis of significant liver fibrosis was 0.68 (0.60 to 0.77), and 0.74 (0.65 to 0.83) for cirrhosis in CHI3L1. Multivariate regression analysis showed that CHI3L1 was an independent predictor of significant fibrosis and cirrhosis. The combined diagnostic model based on CHI3L1, collagen IV and FIB-4 scores further improved the diagnostic value. The area under the curve for the diagnosis of significant fibrosis and cirrhosis was 0.79 (0.72 to 0.86) and 0.80 (0.73 to 0.87), respectively. @*Conclusion@#CHI3L1 has a good diagnostic value in patients with chronic liver disease with significant fibrosis and liver cirrhosis. The diagnostic model in combination with other markers like Collagen IV and FIB-4 scores could further improve the diagnostic value and is worthy of further study.
ABSTRACT
Objective To compare the efficacy and safety of lauromacrogol injection sclerotherapy with ethanol injection sclerotherapy in treating simple liver cysts. Methods A total of 166 patients with simple liver cyst were randomly divided into the lauromacrogol group (study group, n=86) and the absolute alcohol group (control group, n=80). Under ultrasonographic guidance, puncture aspiration of liver cyst was carried out in all patients, which was followed by injection of lauromacrogol for patients in the study group or injection of ethanol for patients in the control group. The therapeutic effect and the side-effect were evaluated. The results were compared between the two groups. Results No serious complications such as bleeding or infection occurred in both groups. During the therapeutic course , 45 patients (56.3%) in the control group felt pain to some degree and 23 patients (28.8%) developed drunk-like symptoms, while no patient in the study group felt any obvious discomfort. One week after sclerotherapy , 20 patients (25%) in the control group complained of distending pain on the right upper abdomen, while only 9 patients (10.5%) in the study group complained of pain, and the difference was statistically significant (χ2= 6.073, P 0.05). Conclusion For the treatment of liver cysts, lauromacrogol injection is safe and effective. Therefore, this technique should be recommended in clinical practice.