[Possibility of Using ELF Score as Index for Hepatic Fibrosis Evaluation].

Liver fibrosis, most commonly caused by hepatitis virus (such as HBV and HCV) infections, excessive alcohol consumption, and obesity-induced steatosis, is characterized by the excessive accumulation of extracellular matrix proteins (including collagen) and an increase in connective-tissue (liver fibrogenesis) in the human liver. Today, while the reference standard for detecting and assessing liver fibrosis is needle biopsy of the liver, this invasive procedure can cause physical and emotional distress for patients. On the other hand, medical imaging systems and various blood markers have been developed and become available for routine laboratory practices. These non-invasive procedures, as well as pathological biopsy, have significantly contributed to assessing liver fibrosis. The Enhanced Liver Fibrosis (ELF) test is a simple blood test to create an ELF score by combining three markers: hyaluronic acid (HA), amino-terminal propeptide of type III procollagen (PIIINP), and tissue inhibitor of metalloproteinase 1 (TIMP-1). The ELF test is one of the promising techniques for diagnosing patients with liver fibrosis.

Serum HER2 levels and HER2 status in tumor cells in advanced gastric cancer patients.

OBJECTIVE: Increased serum human epidermal growth factor receptor 2 levels have been found in metastatic breast cancer patients and are correlated with human epidermal growth factor receptor 2 overexpression in tumor cells. However, the prevalence of serum human epidermal growth factor receptor 2 in gastric cancer patients has not been elucidated. METHODS: We retrospectively analyzed formalin-fixed paraffin-embedded tumor tissues and serum samples from 96 advanced gastric cancer patients. Human epidermal growth factor receptor 2 expression and gene amplification in tumor cells were determined by immunohistochemistry and fluorescence in situ hybridization. Serum human epidermal growth factor receptor 2 levels were measured using a chemiluminescent immunoassay. Human epidermal growth factor receptor 2 positivity in tumor cells was defined as immunohistochemistry 2+ with fluorescence in situ hybridization positive or immunohistochemistry 3+ with any fluorescence in situ hybridization results. RESULTS: All tissue samples and serum samples were successfully measured. Nineteen patients (20%) were human epidermal growth factor receptor 2-positive in tumor cells. The median serum human epidermal growth factor receptor 2 level was 9.3 ng/ml (range, 5.0-332.4 ng/ml), and serum human epidermal growth factor receptor 2 levels were significantly separated according to human epidermal growth factor receptor 2 status in tumor cells (P < 0.0001, Wilcoxon's rank sum test); median serum human epidermal growth factor receptor 2 levels in human epidermal growth factor receptor 2-negative patients and -positive patients were 8.9 (range, 5.0-20.5) and 24.0 (range, 9.7-332.4), respectively. There were 15 serum human epidermal growth factor receptor 2-positive patients (16%) using a cutoff value of 15 ng/ml. The sensitivity and the specificity of serum human epidermal growth factor receptor 2 with respect to human epidermal growth factor receptor 2 positivity in tumor cells were 53 and 94%, respectively. CONCLUSIONS: Serum human epidermal growth factor receptor 2 measurements cannot be substituted for tissue human epidermal growth factor receptor 2 diagnosis in advanced gastric cancer patients. However, serum human epidermal growth factor receptor 2 levels are associated with human epidermal growth factor receptor 2 overexpression in tumor cells. Further investigations of clinical significance of serum human epidermal growth factor receptor 2 as a predictive marker and a therapy-monitoring marker are warranted.