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

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.