Cytokeratin 18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients

Abstract EN

Background : A simple noninvasive test that accurately distinguishes NASH from NAFL as well as determines the disease severity is urgently needed.

Recently, it was found that determination of cytokeratin-18 (CK-18) fragments in the blood, predicts and correlates with histological NASH in which there is development of lobular inflammation, cell ballooning and fibrosis, supporting its usefulness in clinical practice.

Aims : To evaluate the role of CK-18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients.

Patients and methods : 90 subjects were divided into 3 groups : group I : including 30 patients with NASH, group II : including 30 patients with NAFL, and group III : including 30 healthy subjects as control.

Diagnosis of NASH and its discrimination from NAFL was done by liver biopsy.

CK-18 level in plasma was measured for all subjects using ELISA.

Results : CK-18 was significantly elevated in patients of group I in comparison to group II and III patients, with mean ± SD : 460 ± 279, 167 ± 56 and 149 ± 57, respectively, and P value : 0.001.

The (ROC) curve diagnostic performance of CK18 in diagnosis of NASH shows : cutoff value of > 240 U / L, with sensitivity 76.7 %, specificity 95.0 %.

Ck-18 was found to correlate with disease severity assessed by NAS scoring system with P value : 0.001.

Conclusion : Measurement of CK18 in NASH is a useful screening, diagnostic and staging biomarker.