Diagnostic Value of Procollagen III N-terminal Peptide in Children with Chronic Liver Diseases

Abstract

BACKGROUND: Liver fibrosis develops as a result of a variety of chronic liver diseases. The degree of liver fibrosis must be determined before the severity of the disease can be assessed. The gold standard approach is invasive liver biopsy which is linked with pain and complications. Direct measures of extracellular matrix turnover and indirect markers as a reflection of liver dysfunction are two types of biomarkers used to identify liver fibrosis.

AIM: This study aims to evaluate the diagnostic value of procollagen III N-terminal peptide (P-III-N-P) levels in children with chronic liver diseases.

SUBJECTS AND METHODS: Sixty children with chronic liver diseases and 30 healthy children as a control group were included in this study. Medical history, clinical, radiological, laboratory investigations, plasma procollagen III N-terminal peptide levels were determined using ELISA kits were used to assess both groups, histopathological liver biopsy for case group only.

RESULTS: The hepatic group had a statistically significant higher level of procollagen III N-terminal peptide than the control group (median; 2029.5 ng/ml, 620 ng/ml respectively, p < 0.001). In all studied cases, the mean ± SD of APRI, FIB-4 scores, and procollagen III N-terminal peptide levels exhibited a significant tendency of increasing with the progressive fibrosis stage as determined by the histological Ishak scoring system. The level of procollagen III N-terminal peptide was positively correlated with serum biomarkers and the degree of fibrosis in all patients.

CONCLUSION: Serum procollagen III N-terminal peptide level is a useful non-invasive marker for detection of the stage of liver fibrosis in children with chronic liver diseases.