Background/Aim of The Work: Cytokeratin 18 (CK18) is the major intennediate filament protein in the liver and one of the most prominent substrates of caspases during hepatocyte apoptosis. Apoptosis plays a pivotal role in acute as well as in chronic liver diseases. The aim of this study was to detennine serum caspase.
cleaved CK-18 level in patients with'HCV-related chronic liver diseases and hepatocellularcarcinoina (HCC) and to explore its relation to other clinical & biochemical parameters in these patients, and its possible diagnostic value.
Patients & Methods : This study was carried out on 80 Patients; they were categorized into: Group I, included 40 patients with chronic HCV (CHC), liver biopsy was done for them and histological diagnosis was assessed according to Metavir scoring system. Group II, included 20 patients, post-CHC cirrhosis. Group IJI, included 20 patients post-CHC HCC. Sera of patients and 13 healthy volunteers served as a control for parallel evaluation ofa-fetoprotein & CR':18 (a proteolytic neoepitope ofthe caspase) by ELISA-based assays.
Results: In CHC group, serum CK-18 fragments levels showed a significant positive correlation with age (p =0.023), aspartate amino transaminflse (AST) (p =0.022), Metavir activih) grade (p =0.01), as well as viral load (p = 0.02). Elevated CK-18 fragments was found in 30% of those with normal alanine amino transaminase (ALT) patients.CK-18 fragments were significantly higher in patients with HCC, mean j: SD (399.1 :t 301.1 U/l), than the control and both CHC ''and cirrhotic groups (p-value 0.000 for all). In diagnosis of patients with HCC, The area under the ROC curve (AUC) forCK-18 was estimated to be 0.909 at cutoJJ119.3 WI with 95% & 70.4% for sensitivihj and specificihj respectively. Prediction based on CK-18 frllgments was significantly better than that based on a-fetoprotein, AUC 0.834 at cutoff 12.2 ng,mL with 70% &:8.6% for sensitivity and : specificity respec!ipely.
Conclusions: Serum CK-18 is significantly elevated in patients with post CHt malignant liver diseases, and
has positive correlation in those with prominent Cl)tolysis in CHC patients. Further studies are needei to
evaluate the use ofCK-18 as a marker ofliver diseases. |
