<正> OBJECTIVE: To assess the significance of serum hyaluronic acid （HA）, proeollagen type Ⅲ （PCⅢ）,collagen type Ⅳ （CⅣ） in the histological diagnosis of liver fibrosis.METHODS: The concentrations of serum HA, PCⅢ, CⅣ in 253 patients with chronic liver diseases weremeasured by radioimmunoassay. Liver biopsies were performed in all patients at the same time. The liverwas pathologically evaluated by a pathologist according to a scoring system. Combined with the results ofliver pathological diagnosis, the accuracy of serum HA, PCⅢ, CⅣ in diagnosing patients with hepaticfibrosis （staging≥S2） or cirrhosis （S4） was assessed using the receiver operating curve （ROC）.RESULTS: The cutoff values of serum HA, PCⅢ and CⅣ for identifying patients with hepatic fibrosis（≥S2） or cirrhosis （S4） were determined. The cutoff values of serum HA, PCⅢ and CⅣ for detectingpatients with fibrosis （stage≥S2） were 90μg/L, 90μg/L, 75μg/L, respectively; their sensitivity（Se） was 80.4%, 82%, 63.1%; their specificity （Spe） was 70.2%, 60.8%, 83.8%; their positivepredictive values （PPV） were 86.7%, 83.5%, 90.4%; their negative predictive values （NPV） were59.8%, 58.4%, 48.4%, respectively. The cutoff values for detecting patients with liver cirrhosis were210μg/L for HA, 96.2% for Se, 85.3% for Spe, 65.4% for PPV, 98.8% for NPV; 150μg/L forPCⅢ, 76.4% for Se, 68.7% for Spe, 40.4% for PPV, 91.3% for NPV; 90μg/L for CⅣ, 80% forSe, 75.8% for Spe, 47.8% for PPV, 93.2% for NPV, respectively.CONCLUSIONS: Serum HA, PCⅢ and CⅣ can be determined for an accurate diagnosis of hepaticfibrosis in various stages. HA is the best for screening liver cirrhosis.
