CLINICAL SIGNIFICANCE OF SERUM N-TERMINAL PRO C-TYPE NATRIURETIC PEPTIDE IN HEPATITIS C-RELATED CHRONIC LIVER DISEASES

To evaluate the clinical utility of serum levels of n-terminal pro c-type natruretic pep-tide (nt-pro cnp) in patients with hepatitis c related chronic liver disease (cld),in prospective to disease complications and progression. this study included 66 hepatitis c-related cld patients with and without ascites and 15 healthy individuals (control group). serum nt-pro cnp was measured by elisa. a stepwise progressive increase in nt-pro cnp levels was recorded through controls,patients without ascites and patients with ascites (p< 0.05). in addition,patients with hematemesis or encephalopathy had more than its double values than those without (p<0.01). moreover,a significant difference was observed in the marker levels among esophageal varcies stages 1,2,3 (h=13.679,p=0.001),with highest levels in grade 3. nt-pro cnp correlated positively with alpha fetoprotein (rs =0.455,p=0.008) with no significant correlation neither with meld nor child scores (p>0.05). roc curve analysis revealed the overall performance of the marker in discriminating cld patients collectively from controls,the optimum cut-off level was 85 ng/l (auc= 0. 803,sensitivity 84.8%& specificity 53.3%). an increased level of nt-pro cnp is a promising non-invasive marker of hepatitis c related cld complications and disease progression.