Cytokeratin 18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients

ABSTRACT

A simple noninvasive test that accurately distinguishes NASH from NAFL as well as determines the disease severity is urgently needed. Recently, it was found that determination of Cytokeratin-18 [CK-18] fragments in the blood, predicts and correlates with histological NASH in which there is development of lobular inflammation, cell ballooning and fibrosis, supporting its usefulness in clinical practice To evaluate the role of CK-18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients. 90 subjects were divided into 3 groups group I including 30 patients with NASH, group II including 30 patients with NAFL, and group III including 30 healthy subjects as control. Diagnosis of NASH and its discrimination from NAFL was done by liver biopsy. CK-18 level in plasma was measured for all subjects using ELISA. CK-18 was significantly elevated in patients of group I in comparison to group II and III patients, with mean +/- SD 460 +/- 279, 167 +/- 56 and 149 +/- 57, respectively, and/3 value 0.001. The [ROC] curve diagnostic performance of CK18 in diagnosis of NASH shows cutoff value of >240U/L, with sensitivity 76.7%, specificity 95.0%. Ck-18 was found to correlate with disease severity assessed by NAS scoring system with P value 0.001. Measurement of CK18 in NASH is a useful screening, diagnostic and staging bio-marker