BackgroundSerum apoptotic cytokeratine 18 neoepitope M30 (CK-18 M30) and matrix metalloproteinase 2 (MMP-2) have been popular markers for detecting liver fibrosis in recent years. CK-18 is a major intermediate filament protein in liver cells and one of the most prominent substrates of caspases during hepatocyte apoptosis. MMP-2 plays an important role in tissue remodeling and repairing processes during physiological and pathological states.ObjectivesThe objective of this study was to investigate the significance of CK-18 M30 and MMP-2 levels for clinical use in patients with chronic hepatitis B (CHB), as well as their sensitivity in determining cirrhotic patients.Patients and MethodsThis study included 189 CHB patients and 51 healthy controls. A modified Knodell scoring system was used to determine the fibrosis level in chronic hepatitis B patients. CK-18 M30 levels were determined with an M30-Apoptosense ELISA assay. MMP-2 levels were determined with the ELISA assay.ResultsThe study group consisted of 132 (69.8%) males and 57 (30.2%) females, and the control group consisted of 25 males (49.0%) and 26 females (51%). Patients’ CK-18 M30 levels were higher than values of the control group (308 [1–762] vs. 168 [67–287], P=0.001). Serum MMP-2 levels were found to be statistically higher in the patient group with respect to the controls (3.0 [1.1–6.8] vs. 2.0 [1.2–3.4], P=0.001). The highest serum CK-18 M30 and MMP-2 levels were measured in patients with cirrhosis. Serum apoptotic CK-18 M30 levels positively correlated with advanced age, fibrosis stage, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels (P= 0.001, 0.033, 0.001, and 0.001, respectively). Serum MMP-2 levels positively correlated with fibrosis stage, serum ALT, and AST levels (P= 0.001, 0.001, and 0.001, respectively).ConclusionsOur study indicated that CK-18 M30 and MMP-2 levels were higher in CHB patients compared to healthy controls and they were in association with significant hepatic fibrosis, especially cirrhosis.
In this study, we demonstrated that serum HMGB1 levels increase in the early course of liver injury and this increase is not correlated with severity of the liver damage.
SUMMARY. The analytical, intra-individual, inter-individual variation and reference values were determined for red cell glucose-6-phosphate dehydrogenase (G6PD). Different procedures for the conditions for storage of red blood cells and the preparation of haemolysates were investigated.A total of 2170 samples of blood were taken from apparently healthy persons-1212 males and 958 females-from randomly selected villages and city centres in the southern part of Turkey. Analytical variation, intra-individual variation and inter-individual variation were 8· 67%, 32· 8% and 31' 8070, respectively. The mean (SD) for G6PD was 8·6 (3' 3) IU/gHb. The index of individuality, 1,03, showed that the reference intervals could be used for diagnostic purposes.Whole blood or a red cell pellet could be stored in physiological saline for one week at 4°C or -20°with little loss of activity. Two of three different procedures for the preparation of haemolysate gave data that showed no statistical difference and were equally satisfactory.
Background:Platelets are considered an important source of prothrombotic agents associated with inflammation in cancer related diseases. We aimed to compare the diagnostic accuracy of the platelet distribution width (PDW) and CA19-9 in resectable pancreas cancer.Method:A total of 83 stage-1 and 2 pancreatic adenocarcinoma (PAC) patients, and 85 age and sex-matched healthy participants were included in the study. All preoperative patient data, including PDW and CA19-9 were analyzed in terms of sensitivity, specificity, positive and negative predictive values, likelihood ratios, and diagnostic accuracy.Results:Demographic features were not significantly different among the groups. Platelet distribution width and CA19-9 were significantly higher in PAC compared to control group (p= 0.0001). Diagnostically, the sensitivity and specificity were 79% and 85% for PDW, while 78% and 91% for CA19-9. Diagnostic accuracy was measured by the area under the ROC curve, and PDW differs significantly (p<0.001), with a value of 0.874 (95% CI: 0.804-0.929).Conclusion:Platelet distribution width indicated similar sensitivity and specificity with CA19-9 in patients with resectable PAC. This result strongly advice that PDW, which has more routine option and cost-effectivity than CA19-9, can be used for diagnosis of resectable PAC as a strong alternative.
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