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Diagnosing and staging liver fibrosis are critical in guiding the treatment of chronic liver diseases, according to several international and Chinese guidelines. Liver biopsy is the gold standard for diagnosing and staging liver fibrosis, but it is invasive and suffers from several limitations. Consequently, much research has focused on the search for a noninvasive serum biomarker of fibrosis. In this study, we determined that Chitinase 3-like 1 (CHI3L1) is an abundantly expressed liver gene whose expression is highly enriched in the liver. We then compared serum levels of CHI3L1 among patients with various stages of liver fibrosis, as determined by liver biopsies, and found that the CHI3L1 levels were able to differentiate early stages of liver fibrosis (S0\u2013S2) from late stages of liver fibrosis (S3\u2013S4). We further showed that CHI3L1 is a good marker of substantial fibrosis, with areas under the ROC curves (AUCs) of 0.94 for substantial (S2, S3, S4) fibrosis and 0.96 for advanced (S3, S4) fibrosis. Finally, we showed that CHI3L1 is superior to hyaluronic acid (HA), type III procollagen (PCIII), laminin (LN), and type IV collagen (CIV), which are also serum biomarkers of liver fibrosis, in identifying advanced liver fibrosis in patients with HBV-related liver fibrosis in China.<\/jats:p>","DOI":"10.1089\/omi.2015.0037","type":"journal-article","created":{"date-parts":[[2015,6,4]],"date-time":"2015-06-04T03:53:38Z","timestamp":1433390018000},"page":"339-345","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":60,"title":["CHI3L1 Is a Liver-Enriched, Noninvasive Biomarker That Can Be Used to Stage and Diagnose Substantial Hepatic Fibrosis"],"prefix":"10.1177","volume":"19","author":[{"given":"Haijun","family":"Huang","sequence":"first","affiliation":[{"name":"Zhejiang Provincial People's Hospital","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiangang","family":"Wu","sequence":"additional","affiliation":[{"name":"Zhejiang University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Mao","sequence":"additional","affiliation":[{"name":"Zhejiang University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongxing","family":"Fang","sequence":"additional","affiliation":[{"name":"Zhejiang University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial People's Hospital","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Wu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhejiang University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Zheng","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biaoyang","family":"Lin","sequence":"additional","affiliation":[{"name":"Zhejiang University","place":["China"]},{"name":"Zhejiang University School of Medicine","place":["China"]},{"name":"University of Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongying","family":"Pan","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial People's Hospital","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,6,1]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2005.048389"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2004.035899"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1746.2000.02324.x"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12590"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.05.035"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7007-6-49"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365529709025104"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(00)80095-1"},{"key":"e_1_3_3_11_1","first-page":"172","article-title":"Studies on serum YKL-40 as a biomarker in diseases with inflammation, tissue remodelling, fibroses and cancer","volume":"53","author":"Johansen JS","year":"2006","unstructured":"Johansen JS. (2006). Studies on serum YKL-40 as a biomarker in diseases with inflammation, tissue remodelling, fibroses and cancer. Dan Med Bull, 53, 172\u2013209.","journal-title":"Dan Med Bull"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jlb.60.4.540"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0078672"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12026-013-8459-y"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40139-014-0061-z"},{"key":"e_1_3_3_16_1","first-page":"2082","article-title":"Statement: Management of hepatitis C 2002","volume":"123","author":"National Institutes of Health Consensus Development Conference","year":"2002","unstructured":"National Institutes of Health Consensus Development Conference. (2002). Statement: Management of hepatitis C 2002. 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