Photo Credit: Mohammed Haneefa Nizamudeen

The following is a summary of “Enhancing Liver Fibrosis Detection: A Novel PIGR-utilizing Approach in chronic hepatitis B injury assessment,” published in the February 2025 issue of the BMC Gastroenterology by Chu et al.

Chronic Hepatitis B (CHB) remains a major global cause of liver fibrosis and cirrhosis, posing significant challenges for early detection due to the absence of specific symptoms and the limited availability of noninvasive biomarkers with high diagnostic accuracy. Recent research has identified the polymeric immunoglobulin receptor (PIGR) as a promising biomarker for liver fibrosis, though its clinical utility remains under investigation. This study aims to evaluate the diagnostic performance of PIGR in patients with CHB and its potential role as a reliable noninvasive biomarker for liver fibrosis. A retrospective analysis was conducted on 150 patients with CHB treated between 2018 and 2023, classified into two groups based on liver biopsy findings: 34 patients with confirmed liver fibrosis and 116 without fibrosis. 

Clinical parameters, including fibrosis-related serum markers such as collagen type IV (CIV), procollagen type III N-terminal peptide (PCIIINP), hyaluronic acid (HA), and laminin (LN), were analyzed to assess their correlation with PIGR expression. Logistic regression analysis was performed to identify independent predictors of liver fibrosis, and the diagnostic efficacy of PIGR was assessed using receiver operating characteristic (ROC) curve analysis. Results demonstrated significant differences in CIV, PCIIINP, and HA levels between fibrosis and non-fibrosis groups (P < 0.05), with PIGR levels being markedly elevated in patients with fibrosis. Correlation analysis revealed a positive association between PIGR expression and HA, LN, PCIII, and CIV levels (P < 0.05). 

Logistic regression identified HA, LN, PCIIINP, and CIV as significant risk factors for fibrosis, while PIGR emerged as an independent predictor (P < 0.05). ROC analysis demonstrated the strong diagnostic performance of PIGR, yielding an area under the curve (AUC) of 0.839 at a cutoff value of 0.35, with a sensitivity of 81.90%, specificity of 79.41%, and a Youden’s index of 0.613. Additionally, decision curve analysis indicated that PIGR provided a higher net benefit in predicting liver fibrosis compared to the APRI. These findings underscore the clinical potential of PIGR as a novel, noninvasive biomarker for liver fibrosis in patients with CHB. Given its strong correlation with established fibrosis markers and high diagnostic accuracy, PIGR holds promise for improving early detection and risk stratification of liver fibrosis, thereby facilitating timely clinical intervention and personalized treatment strategies.

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-03672-x