the clinical significance of serum apoptotic cytokeratin 18 neoepitope m30 (ck-18 m30) and matrix metalloproteinase 2 (mmp-2) levels in chronic hepatitis b patients with cirrhosis

background serum apoptotic cytokeratine 18 neoepitope m30 (ck-18 m30) and matrix metalloproteinase 2 (mmp-2) have been popular markers for detecting liver fibrosis in recent years. ck-18 is a major intermediate filament protein in liver cells and one of the most prominent substrates of caspases during hepatocyte apoptosis. mmp-2 plays an important role in tissue remodeling and repairing processes during physiological and pathological states. objectives the objective of this study was to investigate the significance of ck-18 m30 and mmp-2 levels for clinical use in patients with chronic hepatitis b (chb), as well as their sensitivity in determining cirrhotic patients. patients and methods this study included 189 chb patients and 51 healthy controls. a modified knodell scoring system was used to determine the fibrosis level in chronic hepatitis b patients. ck-18 m30 levels were determined with an m30-apoptosense elisa assay. mmp-2 levels were determined with the elisa assay. conclusions our study indicated that ck-18 m30 and mmp-2 levels were higher in chb patients compared to healthy controls and they were in association with significant hepatic fibrosis, especially cirrhosis. results the study group consisted of 132 (69.8%) males and 57 (30.2%) females, and the control group consisted of 25 males (49.0%) and 26 females (51%). patients’ ck-18 m30 levels were higher than values of the control group (308 [1–762] vs. 168 [67–287], p=0.001). serum mmp-2 levels were found to be statistically higher in the patient group with respect to the controls (3.0 [1.1–6.8] vs. 2.0 [1.2–3.4], p=0.001). the highest serum ck-18 m30 and mmp-2 levels were measured in patients with cirrhosis. serum apoptotic ck-18 m30 levels positively correlated with advanced age, fibrosis stage, serum alanine aminotransferase (alt) and aspartate aminotransferase (ast) levels (p= 0.001, 0.033, 0.001, and 0.001, respectively). serum mmp-2 levels positively correlated with fibrosis stage, serum alt, and ast levels (p= 0.001, 0.001, and 0.001, respectively).