Abstract: Objective The aim of this study was to investigate the diagnostic performance of serum fibroblast growth factor 21 (FGF-21), platelet-derived growth factor-BB (PDGF-BB) and peripheral blood mononuclear cell (PBMC) fibrosin (FBRS) levels on significant liver fibrosis in patients with chronic hepatitis B (CHB). Methods 92 patients with CHB were enrolled in our hospital between January 2020 and January 2021, and all underwent liver biopsies and liver stiffness measurement (LSM). Serum FGF-21 and PDGF-BB were measured by ELISA, and PBMCs FBRS mRNA was assayed by real-time fluorescent quantitative PCR. The diagnostic performance was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC). Results The liver histopathologic examination showed non-significant liver fibrosis in 49 cases, and significant liver fibrosis in 43 cases; in patients with significant liver fibrosis, serum FGF-21 level was (228.8±52.6)ng/ml, significantly lower than [(289.3±57.9)ng/ml, P<0.05], serum PDGF-BB level was (84.7±32.9)pg/ml, significantly higher than [(44.7±18.5)pg/ml, P<0.05], PBMCs FBRS mRNA load was (8.7±3.2), significantly higher than [(4.4±1.8), P<0.05], and the LSM was (15.6±3.9)kPa, significantly higher than [(7.6±1.8)kPa, P<0.05] in patients with non-significant liver fibrosis; the AUCs were 0.800, 0.714, 0.690 and 0.960 by the FGF-21, PDGF-BB, FBRS and LSM in predicting significant liver fibrosis when the cut-off-values were set at 249.0(ng/ml), 63.5(pg/ml), 7.4 and 11.2(kPa), respectively, with the sensitivities (Se) and specificities (Sp) of 69.8% and 79.6%, 69.8% and 69.4%, 65.1% and 73.5%, and 93.3% and 98.0%, but the AUC was 0.989 by the combination of the four parameters, with the Se and Sp of 95.3% and 63.3%. Conclusion The combination of serum FGF-21 and PDGF-BB, PBMCs FBRS mRNA and LSM in predicting liver fibrosis in patients with CHB could improve the Se, but the Sp is still not high, which needs further clinical investigation.

Key words: Hepatitis B, Liver fibrosis, Fibroblast growth factor 21, Platelet-derived growth factor-BB, Fibrosin, Liver stiffness measurement, Diagnosis