Clinical Benefits of Biochemical Markers of Fibrosis in Egyptian Children With Chronic Liver Diseases.

BACKGROUND: The need for repetition of liver biopsy, especially in assessing the degree of fibrosis and follow-up of treatment protocols, justifies an intensive search for non-invasive alternatives. We attempted to investigate the clinical usefulness of serum fibrogenesis markers in pediatric chronic liver diseases. METHODS: We measured serum levels of TGF-ß1, collagen IV, laminin, MMP-2 and EGF-R, in 50 children with chronic liver disease (HBV, HCV and Bilharziasis) and 30 healthy controls, and determined their relationship to frequently used liver function tests and liver biopsy findings in patients. RESULTS: TGF-ß1, collagen IV, laminin and MMP-2, but not EGF-R, were significantly higher in patients than in controls (P < 0.01). None of these markers correlated with the histological fibrosis stage, whereas laminin correlated with necroinflammatory activity (P < 0.01). TGF-ß1, collagen IV, laminin and MMP-2 had the ability to discriminate patients with significant fibrosis, while only collagen IV and laminin were able to discriminate those with cirrhosis. Among these markers, collagen IV had the best predictive accuracy for significant fibrosis (AUROC 0.94; PPV 91.5%) and cirrhosis (AUROC 0.85; PPV 80%). CONCLUSIONS: In conclusion, these markers may be useful in reducing but not replacing the need for liver biopsy in the monitoring of disease progression and treatment effectiveness and might be an inseparable part of assessment of chronic hepatopathies.

Determination of the optical properties of a two-layer tissue model by detecting photons migrating at progressively increasing depths.

We have investigated a method for solving the inverse problem of determining the optical properties of a two-layer turbid model. The method is based on deducing the optical properties (OPs) of the top layer from the absolute spatially resolved reflectance that results from photon migration within only the top layer by use of a multivariate calibration model. Then the OPs of the bottom layer are deduced from relative frequency-domain (FD) reflectance measurements by use of the two-layer FD diffusion model. The method was validated with Monte Carlo FD reflectance profiles and experimental measurements of two-layer phantoms. The results showed that the method is useful for two-layer models with interface depths of >5 mm; the OPs were estimated, within a relatively short time (<1 min), with a mean error of <10% for the Monte Carlo reflectance profiles and with errors of <25% for the phantom measurements.