COMP serum levels: A new non-invasive biomarker of liver fibrosis in patients with chronic viral hepatitis

Abstract

Background & aims Recently we have shown that cartilage oligomeric matrix protein (COMP), a fibrillar collagen assembly regulator, is strongly associated with cirrhosis and hepatocellular carcinoma progression. Therefore, we assessed whether serum COMP levels can be used as a non-invasive fibrosis marker in patients with chronic viral hepatitis (CVH) and compared this marker with standard methods for disease stage assessment [histology, transient elastography (TE), APRI, FIB-4]. Methods Sera from 116 CVH patients, 66 HBV [24 female; median age 53(22–76)] and 50 HCV [21 female; median age 48.5(25–69)] were investigated by COMP-ELISA. APRI and FIB-4 score was calculated in all along with TE. Liver biopsy was performed in 61. Patients were divided into two groups (F1/F2 and F3/F4) according to Metavir score. Results 55/116 (47%) CVH patients were classified in F3/F4-group according to TE [14.3(9.3–75) kPa]. APRI score was > 1.5 in 21/116 and FIB-4 > 3.25 in 20/116. Liver histology revealed 24/61 (39%) patients with significant fibrosis (stage 3–4), while 12/61 (19.7%) had cirrhosis. COMP levels correlated with TE measurements (r = 0.5; p < 0.001) and APRI score (r = 0.23; p < 0.02). The diagnostic accuracy of COMP in detecting cirrhosis was as good as TE, APRI and FIB-4 index (AUC 0.884) with sensitivity and specificity of 83.3% and 83.7% (cut-off 11.5 U/L). Conclusions COMP serum levels performed as well as TE, APRI and FIB4 score in detecting cirrhosis in CVH patients, suggesting COMP as a sensitive non-invasive, easy to perform biomarker of liver fibrosis. Further studies are needed in order to validate our findings in CVH patients. © 2017 European Federation of Internal Medicine