Naif kronik viral hepatit b'li hastalarda antiviral tedavinin karaciğerdeki inflamasyon ve fibrozis skorlarına etkisinin serum galectin-3 düzeyi ile değerlendirilmesi
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Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada, karaciğer biyopsisi sonrası kronik hepatit B tanısı konmuş hastalarda, serum galectin-3 düzeyinin tedavi öncesi ve sonrası serum düzeylerini tespit etmek, tedavi sonrası serum düzeylerindeki olası değişimin fibrozis derecesi ile ilişkili olup olmadığını göstermek, galectin-3'ün karaciğer fibrozisindeki düzelmeyi ve tedavi yanıtını öngörebilecek bir biyolojik belirteç olup olamayacağını araştırmak amaçlanmıştır. Materyal ve Metod: Çalışmaya Kırıkkale Üniversitesi Gastroenteroloji Bilim Dalı polikliniğine başvuran, biyokimyasal ve histolojik olarak Hepatit B tanısı almış 40 hasta ve bilinen herhangi bir hastalığı olmayan HBsAg negatif, karaciğer fonksiyon testleri normal 30 kişi dahil edilmiştir. Galectin-3 düzeyi ELISA yöntemi ile ölçülmüştür. Fibrozis modelleri ise orijinal makaledeki formüller ile hesaplanmıştır. Fibrozis evresi Ishak skorlama sistemine göre değerlendirilmiştir. Bulgular: Çalışmamızdaki hastaların tedavi öncesi ve sonrasındaki serum galectin3 düzeyleri karşılaştırıldığında, tedavi öncesinde hastaların galectin-3 değerlerinin anlamlı derecede yüksek olduğu görülmüştür. Yapılan ROC-Curve analizinde galectin-3 belirtecinin naif hastaları, tedavi sonrası durumlarından istatistiksel olarak anlamlı şekilde ayırt edebildiği görülmüştür (AUROC=0,660, p=0,010). Galectin-3 değişkeninin >11,7 düzeyinde duyarlılık %62,5 ve seçicilik %75 ile naif hastalardaki fibrozis durumunu tedavi sonrası fibrozis durumlarından ayırt edebileceği öngörülmüştür. Çalışmamızda naif hastaların APRI ve FIB-4 düzeyleri kontrol grubuna göre istatistiksel olarak anlamlı düzeyde yüksek bulunmuş, bu değerlerin naif hastaların tanısında istatistiksel olarak anlamlı tanı değeri taşıdığı (AUROC 0,773, 0,733) bulunmuştur. Yine bu değerlerin tedavi sonrasında anlamlı şekilde düşüş gösterdiği saptanmıştır. ix Sonuç: Bu bulgular, tedavi sonrası fibrozisteki gerileme ile birlikte galectin-3 değerinin de düştüğünü; tedavi başarısının galectin-3 düzeyi ile değerlendirilebileceğini göstermektedir. Ancak galectin-3'ün karaciğer fibrozisi tanısında kullanılmak üzere fibrozisle ilişkisini değerlendirmeye yönelik daha fazla çalışmaya ihtiyaç vardır. Anahtar Kelimeler: Kronik hepatit B, karaciğer fibrozisi, Galectin-3
Objective: In this study, we examined the relationship between galectin-3 levels before and after treatment and the possible change in serum levels after treatment with the degree of liver fibrosis in patients diagnosed with chronic hepatitis B after liver biopsy. Thus, we aimed to determine whether galectin-3 can be a biomarker that can predict the improvement in liver fibrosis and treatment response. Materials and Methods: The study was carried out in Kırıkkale University Gastroenterology Department outpatient clinic. Forty patients who applied to the clinic, diagnosed with hepatitis B biochemically and histologically, and 30 patients with no known disease, HBsAg negative, and normal liver function tests were included. Galectin-3 level was measured by ELISA method. Fibrosis models were calculated using the formulas in the original article. Fibrosis stage was evaluated according to the Ishak scoring system. Findings: The serum galectin-3 levels of the patients in our study were compared before and after the treatment, and it was seen that the galectin-3 values of the patients were significantly higher before the treatment. In the ROC-Curve analysis, it was observed that the galectin-3 marker could significantly distinguish naive patients from their post-treatment status (AUROC=0.660, p=0.010). It was predicted that Galectin3 variable above the level of 11.7 could distinguish fibrosis status in naïve patients from post-treatment fibrosis with 62.5% sensitivity and 75% specificity. In our study, the APRI and FIB-4 levels of naive patients were found to be statistically significantly higher than the control group, and these values were found to have statistically significant diagnostic value (AUROC 0.773, 0.733) in the diagnosis of naive patients. It was also determined that these values decreased significantly after the treatment. xi Conclusion: These findings show that galectin-3 level decreases with the regression in fibrosis after treatment and the success of treatment can be evaluated by galectin-3 level. However, more studies are needed to evaluate the relationship between galectin-3 and fibrosis for use in the diagnosis of liver fibrosis. Keywords: Chronic hepatitis B, liver fibrosis, Galectin-3
Objective: In this study, we examined the relationship between galectin-3 levels before and after treatment and the possible change in serum levels after treatment with the degree of liver fibrosis in patients diagnosed with chronic hepatitis B after liver biopsy. Thus, we aimed to determine whether galectin-3 can be a biomarker that can predict the improvement in liver fibrosis and treatment response. Materials and Methods: The study was carried out in Kırıkkale University Gastroenterology Department outpatient clinic. Forty patients who applied to the clinic, diagnosed with hepatitis B biochemically and histologically, and 30 patients with no known disease, HBsAg negative, and normal liver function tests were included. Galectin-3 level was measured by ELISA method. Fibrosis models were calculated using the formulas in the original article. Fibrosis stage was evaluated according to the Ishak scoring system. Findings: The serum galectin-3 levels of the patients in our study were compared before and after the treatment, and it was seen that the galectin-3 values of the patients were significantly higher before the treatment. In the ROC-Curve analysis, it was observed that the galectin-3 marker could significantly distinguish naive patients from their post-treatment status (AUROC=0.660, p=0.010). It was predicted that Galectin3 variable above the level of 11.7 could distinguish fibrosis status in naïve patients from post-treatment fibrosis with 62.5% sensitivity and 75% specificity. In our study, the APRI and FIB-4 levels of naive patients were found to be statistically significantly higher than the control group, and these values were found to have statistically significant diagnostic value (AUROC 0.773, 0.733) in the diagnosis of naive patients. It was also determined that these values decreased significantly after the treatment. xi Conclusion: These findings show that galectin-3 level decreases with the regression in fibrosis after treatment and the success of treatment can be evaluated by galectin-3 level. However, more studies are needed to evaluate the relationship between galectin-3 and fibrosis for use in the diagnosis of liver fibrosis. Keywords: Chronic hepatitis B, liver fibrosis, Galectin-3
Açıklama
Tıp Fakültesi, İç Hastalıkları Ana Bilim Dalı
Anahtar Kelimeler
Gastroenteroloji, Gastroenterology
