# Superior Diagnostic Efficacy of N‐Terminal Propeptide of Type III Collagen and Golgi Protein 73 for Detection of Fibrosis in Chronic Hepatitis B Patients

## TL;DR

This study shows that PRO-C3 and GP73 are effective blood markers for detecting liver fibrosis in chronic hepatitis B patients, with PRO-C3 being the most accurate.

## Contribution

The study demonstrates that PRO-C3 alone or combined with GP73 outperforms existing methods in detecting liver fibrosis in CHB patients.

## Key findings

- PRO-C3 and GP73 levels were significantly higher in patients with significant and advanced fibrosis.
- The combination of PRO-C3 and GP73 showed higher diagnostic accuracy than FIB-4, APRI, and other non-invasive tests.
- PRO-C3 alone had the highest area under the curve for detecting significant and advanced liver fibrosis.

## Abstract

Significant liver fibrosis is an indication for antiviral therapy in chronic hepatitis B (CHB). Using liver histology assessed by Scheuer system, we evaluated the diagnostic performance of PRO‐C3, GP73, and their combination for the presence of liver fibrosis, and compared them with FIB‐4, APRI, Agile 3+, FAST, and LSM in treatment‐naïve CHB patients from two centers. The study included 324 patients, of whom 167 had S2–4 (significant fibrosis) and 83 had S3–4 (advanced fibrosis). PRO‐C3 levels were higher in those with S2–4 and S3–4 compared with S0–1 and S0–2 (both p < 0.001), with similar findings for GP73. PRO‐C3 and GP73 were independently associated with S2–4 and S3–4 in multivariable analyses. The area under the curves (AUCs) of PRO‐C3 for S2–4 and S3–4 were 0.81 and 0.80, respectively, and exceeded those of GP73 (0.75 and 0.73). The combination of PRO‐C3 and GP73 also had significantly higher AUCs for both S2–4 (0.84 vs. 0.64) and S3–4 (0.80 vs. 0.65) as compared with FIB‐4, with similar findings for APRI, GP73, LSM, FAST, and Agile 3+ for S2–4. In conclusion, PRO‐C3 alone or in combination with GP73 is highly predictive for detecting significant liver fibrosis among CHB patients.

Using liver histology as the gold standard, our study demonstrated that while the diagnostic performance of PRO‐C3 and GP73 is further enhanced when used in combination, PRO‐C3 alone represents a highly predictive serum biomarker for detecting significant liver fibrosis in CHB patients.