Abstract: Objective The aim of this study was to explore the clinical evaluation of liver fibrosis (LF) by serum N-oligosaccharide and total bile acid (TBA) levels and liver stiffness measurement (LSM) combination in patients with chronic hepatitis C (CHC). Methods A total of 84 patients with CHC and 51 healthy individuals were enrolled in our hospital between June 2018 and June 2021. Serum TBA levels were detected by full-automatic biochemical analyzer. The relative content of serum N-oligosaccharide was detected and calculated with data analysis software. The LSM was detected by Fibroscan-502. The diagnostic value of combined parameters was evaluated by area under the receiver operating characteristic (ROC) curve (AUC). Results Serum N-oligosaccharide and TBA levels in patients with CHC were(4.1±0.8) and (20.0±3.1)μmol/L, significantly higher than [(1.6±0.3) and (8.6±1.5)μmol/L, and the LSM was (16.7±2.9)kPa, significantly higher than [(6.3±0.4)kPa, P<0.05] in the control; the liver histopathological examination showed LF S₁ in 19 cases, S₂ in 21 cases, S₃ in 26 cases and S₄ in 18 cases; serum N-oligosaccharide levels in patients with S₁, S₂, S₃ and S₄ were (2.5±0.6), (3.8±0.7), (4.3±0.7) and (5.7±1.0), serum TBA levels were (11.3±2.5)μmol/L, (18.5±3.1)μmol/L, (21.4±3.7)μmol/L and (28.7±4.1)μmol/L, and the LSM were (6.3±1.7)kPa, (13.8±2.1)kPa, (17.9±3.2)kPa and (29.4±4.6)kPa, suggesting they increased as the LF severer (P<0.05); the AUC by the three parameter combination in predicting LF was 0.918(95%CI:0.862-0.973, with Se of 90.9%, Sp of 77.5% and Ac of 84.5%), significantly higher than [0.785(95%CI:0.675-0.894), with Se of 93.2%, Sp of 67.5% and Ac of 81.0%] by serum N-oligosaccharide levels, or [0.769(95%CI:0.668-0.870), with Se of 68.2%, Sp of 77.5% and Ac of 72.6%] by serum TBA levels or [0.802(95%CI:0.708-0.895), with Se of 75.0%, Sp of 80.0% and Ac of 77.4%] by LSM alone(P<0.05). Conclusion The combination of serum N-oligosaccharides and TBA levels as well as LSM is of evaluation value for severity of liver fibrosis in patients with CHC, which needs further investigation.

Key words: Hepatitis C, N-oligosaccharide, Bile acid, Liver stiffness measurement, Liver fibrosis, Diagnosis