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

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. © 2014 .