Abstract: Objective The aim of this study was to explore the predictive value of serum microRNAs (miR)-21 and miR-148b for liver histopathological inflammation grading and fibrosis staging in patients with chronic hepatitis B (CHB). Methods 134 patients with CHB were enrolled in our hospital between July 2016 and June 2021, and all underwent liver biopsy. The liver tissue inflammation grading (G) and fibrosis staging (S) was evaluated. Serum miR-21 and miR-148b levels were detected by real-time quantitative PCR. The diagnostic efficacy of serum miR-21 and miR-148b levels in predicting liver damages was carried out by the area under the receiver operating characteristic curve (AUROC). Results The liver histopathological examination showed G1 in 23 cases, G2 in 39 cases, G3 in 47 cases and G4 in 25 cases, and S1 in 31 cases, S2 in 46 cases, S3 in 28 cases and S4 in 29 cases out of our 134 patients with CHB; serum miR-21 levels in patients with G1, G2, G3 and G4 were (1.1±0.2), (1.5±0.3), (1.8±0.4) and (2.2±0.6), and serum miR-148b levels were (2.4±0.5), (2.0±0.3, (1.6±0.5) and (1.2±0.4), significantly different among them (P＜0.05); serum miR-21 levels in patients with S1, S2, S3 and S4 were (0.9±0.4), (1.4±0.3), (1.9±0.5) and (2.7±0.5), and serum miR-148b levels were (2.8±0.7), (1.9±0.4), (1.4±0.4) and (0.9±0.2), significantly different among them (P＜0.05); the AUC was 0.875 in predicting significant liver inflammatory activities by the combination of serum miR-21 and miR-148b when serum miR-21=1.5 and miR-148b=2.0 were set as the cut-off-value, significantly higher than by any of the two alone (0.769 and 0.781, respectively, P＜0.05), with the sensitivity (Se), specificity (Sp) and accuracy (Ac) of 87.0%, 82.9% and 83.6%; and the AUC was 0.898 by the combination of the two parameters in predicting significant liver fibrosis when serum miR-21 =1.4 and miR-148b=1.9 were set as the cut-off-value, significantly higher than by any one of the two alone (0.782 and 0.770, respectively, P＜0.05), with the Se of 87.1%, Sp of 73.8% and Ac of 76.9%. Conclusion The diagnostic efficacy by serum miR-21 and miR-148b levels in predicting liver histopathogical injuries in patients with CHB might be high, and needs further investigation.

Key words: Hepatitis B, MicroR-21, MiR-148b, Liver inflammation grading, Fibrosis staging, Prediction