Serum Cytokeratin-18 levels as a prognostic biomarker in advanced liver disease: a comprehensive meta-analysis.

Autor: Zhang X; Department of Gastroenterology, The Fourth Hospital of Changsha, Changsha City, Hunan Province, 410006, People's Republic of China., Li J; Department of Gastroenterology, The Fourth Hospital of Changsha, Changsha City, Hunan Province, 410006, People's Republic of China., Jiang L; Department of Gastroenterology, The Fourth Hospital of Changsha, Changsha City, Hunan Province, 410006, People's Republic of China., Deng Y; Department of Gastroenterology, The Fourth Hospital of Changsha, Changsha City, Hunan Province, 410006, People's Republic of China., Wei L; Department of Gastroenterology, The Fourth Hospital of Changsha, Changsha City, Hunan Province, 410006, People's Republic of China., Li X; Department of Critical Care Medicine, Changsha Hospital of Traditional Chinese Medicine (Changsha No. 8 Hospital), 22 Xingsha Avenue, Changsha City, Hunan Province, 410100, People's Republic of China. 875595327@qq.com.
Jazyk: angličtina
Zdroj: Clinical and experimental medicine [Clin Exp Med] 2024 Jul 18; Vol. 24 (1), pp. 160. Date of Electronic Publication: 2024 Jul 18.
DOI: 10.1007/s10238-024-01423-y
Abstrakt: Cytokeratin-18 (CK-18) is a marker of hepatic cell death. Serum CK-18 could serve as a prognostic marker for patients with advanced liver disease (ALD). This meta-analysis aims to explore the association between total CK-18 (M65) and caspase-cleaved CK-18 (M30) levels with the prognosis of ALD patients. Relevant longitudinal observational studies were identified through comprehensive searches of the Medline, Web of Science, and Embase databases. A random-effects model was utilized to synthesize the findings, accommodating heterogeneity among studies. The analysis included 14 datasets from 11 studies. Elevated serum CK-18 levels at admission were linked to a higher risk of death or liver transplantation during follow-up. This association was consistent for both M65 (risk ratio [RR] 1.99, 95% confidence interval [CI] 1.65 to 2.40, p < 0.001; I 2  = 43%) and M30 (RR 1.94, 95% CI 1.57 to 2.40, p < 0.001; I 2  = 46%). Subgroup analysis revealed that the relationship between serum M65 levels and adverse outcomes was attenuated in studies using multivariate analysis compared to those using univariate analysis (RR 1.78 vs. 2.80, p for subgroup difference = 0.03). Further subgroup analyses indicated that the prognostic significance of CK-18 for ALD patients was not significantly influenced by study design, methods of determining CK-18 cutoff values, or follow-up durations. Elevated serum CK-18 levels at admission indicate a poor prognosis in patients with ALD. This finding holds for both M65 and M30.
(© 2024. The Author(s).)
Databáze: MEDLINE
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