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Article Type

Original Study

Abstract

Background Osteopontin (OPN) is a phosphorylated acidic glycoprotein. Its expression increases during pathogenesis of hepatic fibrosis. However, its clinical usefulness in the pathogenesis of liver disease remains obscure. Objective We aimed to evaluate the role of OPN in the degree of hepatic fibrosis in chronic hepatitis C virus (HCV) patients and hepatocellular carcinoma (HCC) patients. Patients and methods This study was conducted on 85 patients who were divided into four groups. Group A consisted of 15 HCV patients with decompensated liver cirrhosis. Group B consisted of 20 HCV patients with HCC. Group C consisted of 35 HCV patients with compensated fibrosis. Group D consisted of 15 age-matched and gender-matched normal controls. All participants underwent full history taking, clinical examination, and laboratory investigations including tests for evaluation of complete blood count, alanine transaminase, aspartate transaminase, international normalized ratio, serum albumin, serum bilirubin, and serum creatinine, abdominal ultrasonography, Fibroscan, and determination of serum OPN level by ELISA. Results Plasma OPN level was highly significantly increased among HCV patients (153.9 ± 48.4) than among controls (47.1 ± 14.5). Also plasma OPN level was higher in group A (181.8 ± 20) than in groups B, C, and D (144.5 ± 12.7, 67.4 ± 18.4, and 47.1 ± 14.5 ng/ml, respectively). There was a significant positive correlation between OPN and both international normalized ratio and bilirubin and a significant negative correlation between OPN and both platelet and serum albumin levels. Moreover, there was a significant increase in OPN levels in patients with extensive fibrosis than in those with mild fibrosis (P = 0.001). The OPN level increased gradually from F1 to F4 (F1, 34.2 ± 4.50; F2, 62.1 ± 10.8; F3, 92.4 ± 16.4; and F4, 173.2 ± 61.5). Regarding the diagnostic validity of serum OPN in cases of liver cirrhosis (F4 versus F1, F2, and F3), the cutoff point was 91 ng/ml, specificity was 81%, sensitivity was 64%, and diagnostic accuracy was 73%. The area under the receiver operating characteristics curve was 0.839, suggesting its good diagnostic accuracy in the prediction of liver cirrhosis (F4). Conclusion The present study indicates that OPN level reflects the degree of hepatic fibrosis and can be used as a good biomarker for assessing the severity of liver fibrosis in HCV patients. Furthermore, serum OPN serves as a prognostic index of the progression of hepatic fibrosis to decompensated cirrhosis and HCC.

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