TET3 as non-invasive screening tool for the detection of fibrosis in patients with chronic liver disease

Ten-eleven translocation protein 3 (TET3) is one of the key enzymes in DNA demethylation which can be expressed in liver tissues. However, the clinical value of TET3 for diagnosis and treatment have not been reported previously. Here, we investigated whether TET3 can be detected by serological methods and evaluate the diagnostic accuracy of serum TET3 for non-fibrotic hepatitis, fibrotic hepatitis and cirrhosis. 212 patients with chronic liver disease (CLD) from were enrolled in this study. Clinical and biochemical data of all cases were obtained. Enzyme-linked immunosorbent assay was used to measure the serum levels of TET3. Receiver operating characteristics (ROC) were determined to examine the diagnostic accuracy of TET3 and combination model for diagnosis fibrosis. Univariable and multivariate analyses showed that levels of TET3 and FIB-4 index were independent predictors of liver fibrosis and cirrhosis. The areas under the ROC curve of the TET3 level and fibrosis-4 index for liver fibrosis were 0.863 and 0.813, and 0.916 and 0.957 for liver cirrhosis. When the TET3 level was associated with fibrosis-4 index, the AUROC was 0.943 for liver fibrosis and 0.990 for liver cirrhosis. The TET3-fibrosis-4 model showed a highly promising positive predictive value for detecting liver fibrosis and cirrhosis different stages of (93.50% and 100%, respectively) as compared with each diagnostic tool alone. TET3 is related to the development of liver fibrosis and cirrhosis. The TET3-fibrosis-4 model could enhance discriminatory power which could be represented a promising non-invasive tool for diagnosis and screening of liver fibrosis and cirrhosis.