CLINICAL-SIGNIFICANCE OF SERUM HYALURONAN IN PATIENTS WITH CHRONIC VIRAL LIVER-DISEASE

In order to elucidate the clinical significance of serum hyaluronan in chronic viral hepatitis, serum hyaluronan concentrations were measure d using a Sandwich enzyme binding assay in 115 patients with chronic v iral hepatitis. These findings were examined in relation to the result s of laboratory liver tests, levels of serum markers for fibrosis and liver histological findings. Serum hyaluronan levels increased with th e progress of liver disease, particularly in liver cirrhosis. There we re no significant differences in serum hyaluronan levels among the cir rhotic patients according to Child's grade. Multivariate analysis show ed that the significant independent predictors of serum hyaluronan wer e serum aspartate aminotransferase (P = 0.020), serum alanine aminotra nsferase (P = 0.008), serum cholinesterase (P < 0.001), particularly s erum type IV collagen 7S domain (P < 0.0001), and the histological deg ree of liver fibrosis (P < 0.0001). These findings suggest that elevat ed serum hyaluronan levels are closely related to the severity of live r fibrosis. We assessed the predictive value of serum hyaluronan in di fferentiating cirrhosis from chronic hepatitis, constructing receiver operating curves; we found that serum hyaluronan was a better test for diagnosing cirrhosis thin serum type IV collagen 7S domain and labora tory liver tests.