{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T13:15:09Z","timestamp":1774012509238,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T00:00:00Z","timestamp":1646956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Up to 30% of patients with severe alcoholic hepatitis (sAH) die within 3 months of presentation. The degree of ductular reaction, characterized by accumulation of biliary and liver progenitor cells, confers a poor prognosis. Keratin fragments are established serological surrogates of liver injury and keratin 19 (K19) is a histological marker of the ductular reaction. We assessed the relationship between serum K19 levels (viz. CYFRA21\u20101), histology and outcome in patients with sAH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Serum CYFRA21\u20101 was quantified in pre\u2010treatment serum samples from 824 patients enrolled in the STOPAH trial. The cohort was randomly divided into two groups to test mortality associations; histological analyses were performed using the 87 cases with suitable samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CYFRA21\u20101 levels were elevated in sAH and strongly predicted alcoholic steatohepatitis (ASH) on biopsy (area under the receiver operated characteristic [AUROC] 0.785 [95% Confidence Interval 0.602\u20130.967]) and 90\u2010day survival (AUROC 0.684\/0.693). The predictive ability of CYFRA21\u20101 was comparable with the model of end\u2010stage liver disease (MELD) score and was independently associated with survival in multivariable analysis. CYFRA21\u20101 moderately correlated with hepatocellular injury markers M30\/M65 but displayed a more robust predictive ability. A combination of MELD and CYFRA21\u20101 conferred a modest improvement in the AUROC value (0.731\/0.743).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In sAH serum, CYFRA21\u20101 levels associate with the presence of ASH on biopsy and independently predict 90\u2010day survival. As a single marker performance is comparable to established scoring systems. Therefore, CYFRA21\u20101, which is available in many clinical laboratories, may become a useful component of prognostic models.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15218","type":"journal-article","created":{"date-parts":[[2022,2,27]],"date-time":"2022-02-27T15:08:35Z","timestamp":1645974515000},"page":"1049-1057","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Serum keratin 19 (<scp>CYFRA21<\/scp>\u20101) is a prognostic biomarker in severe alcoholic hepatitis"],"prefix":"10.1111","volume":"42","author":[{"given":"Stephen Rahul","family":"Atkinson","sequence":"first","affiliation":[{"name":"Department of Metabolism Digestion and Reproduction, Imperial College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Aly","sequence":"additional","affiliation":[{"name":"Medical Clinic III, Gastroenterology, Metabolic diseases and Intensive Care University Hospital RWTH  Aachen Germany"},{"name":"Faculty of Veterinary Medicine, Department of Medicine and Infectious Diseases University of Sadat City  Sadat City Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Remih","sequence":"additional","affiliation":[{"name":"Medical Clinic III, Gastroenterology, Metabolic diseases and Intensive Care University Hospital RWTH  Aachen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke David","family":"Tyson","sequence":"additional","affiliation":[{"name":"Department of Metabolism Digestion and Reproduction, Imperial College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nurdan","family":"Guldiken","sequence":"additional","affiliation":[{"name":"Medical Clinic III, Gastroenterology, Metabolic diseases and Intensive Care University Hospital RWTH  Aachen 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