Role of procollagen type Ⅲ N-terminal peptide in non-invasive diagnosis and therapeutic efficacy monitoring of early liver fibrosis

YAN Huimin; MI Yujing; LIU Tongfang; ZHAO Jing; JIN Suli; LIU Rongxin; WANG Xiaoyu

doi:10.3969/j.issn.1002-3429.2025.22.009

Abstract：Objective To explore the application value of procollagen type Ⅲ N-terminal peptide(PⅢNP)in the non-invasive diagnosis and therapeutic effect evaluation of early-stage liver fibrosis.Methods A retrospective analysis was conducted on 212 patients who underwent liver biopsy from January to September 2024.They were divided into the S1-S2 liver fibrosis group(n=131)and the S3-S4 liver fibrosis group(n=81)according to different degrees of liver fibrosis.Another 105 patients with non-alcoholic fatty liver disease without liver fibrosis,91 patients with alcoholic fatty liver disease and 97 healthy physical examination were selected as the non-alcoholic fatty liver disease group,the alcoholic fatty liver disease group and the healthy physical examinee group,respectively.The levels of serum liver fibrosis indicators[P Ⅲ NP,hyaluronic acid(HA),laminin(LN),type Ⅳ collagen(C-Ⅳ)]in each group were compared,and their diagnostic value for early-stage liver fibrosis and their relationship with therapeutic effects were analyzed.Results Before treatment,the levels of serum P ⅢNP,HA,LN and C-Ⅳin patients with liver fibrosis in both groups were higher than those in the healthy physical examination group,the non-alcoholic fatty liver disease group and the alcoholic fatty liver disease group,and the levels in the S3-S4 liver fibrosis group were higher than those in the S1-S2 liver fibrosis group(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the ROC curve(AUC),sensitivity and specificity of PⅢNP in diagnosing S1-S2 liver fibrosis were 0.822,70.23％and 84.53％respectively,and its AUC was higher than that of HA(0.781),LN(0.733)and C-Ⅳ(0.752)alone.The AUC,sensitivity and specificity of PⅢNP in the diagnosis of S3-S4 liver fibrosis were 0.791,72.84％and 74.05％respectively,and its AUC was higher than that of HA(0.714),LN(0.729)and C-Ⅳ(0.755)alone.At 6 months after the treatment,61 patients were reexamined.Spearman correlation analysis showed that liver fibrosis stage after treatment was positively correlated with serum PⅢNP,HA,LN,and C-Ⅳ(P＜0.001).Conclusion PⅢNP is a good indicator for the auxiliary diagnosis of early-stage liver fibrosis and has certain clinical application value in the evaluation of disease progression and therapeutic effect monitoring of patients.