Diagnostic value of serum YKL-40 for liver fibrosis stage: A meta-analysis

Objective To explore the diagnostic value of serum YKL-40 for liver fibrosis stage, and to provide a reference for noninvasive diagnosis of liver fibrosis in patients with chronic liver disease. Methods We searched Pub Med, EMBASE, the Cochrane Library, Web of Science, and CNKI for studies on the clinical value of YKL-40 in the diagnosis of liver fibrosis or cirrhosis. The quality of studies was evaluated using the QUADAS-2 tool to assess the risk of bias. Comprehensive quantitative evaluation of the included studies was performed using Stata 12. 0. The source of heterogeneity was analyzed, and the forest plot and summary receiver operating curve (SROC) were generated. Results A total of nine studies involving 1592 patients were included in the meta-analysis; six studies were conducted on significant fibrosis (≥F2) , and seven studies were conducted on progressive fibrosis (≥F3) . In the diagnosis of significant fibrosis (≥F2) , YKL-40 had pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, odds ratio, and area under the SROC (AUC) of0. 78 (95% confidence interval [CI]: 0. 69-0. 85) , 0. 53 (95% CI: 0. 33-0. 72) , 1. 7 (95% CI: 1. 0-2. 7) , 0. 41 (95% CI: 0. 21-0. 76) , 4 (95% CI: 1-13) , and 0. 76 (95% CI: 0. 72-0. 80) , respectively. In the diagnosis of progressive fibrosis (≥F3) , YKL-40 had pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, odds ratio, and AUC of 0. 83 (95% CI: 0. 76-0. 89) , 0. 72 (95% CI: 0. 62-0. 80) , 3. 0 (95% CI: 2. 0-4. 4) , 0. 23 (95% CI: 0. 14-0. 37) , 13 (95% CI: 5-30) , and 0. 85 (95% CI: 0. 82-0. 88) , respectively. Conclusion The diagnostic value of serum YKL-40 for significant and progressive liver fibrosis is limited, so it may not be a new, effective serum marker for the staging of liver fibrosis.