Veniently used in clinical practice, especially in developing countries for differentiating significant fibrosis with mild fibrosis in patients with chronic hepatitis B. Liver stiffness is believed one of best non-invasive methods for evaluation liver fibrosis stage and disease progression. However, one question is what optimal cut-off value being chosen for fibrosis grading. Because numerous investigations provided different cut-off value for liver fibrosis classification, it was difficult to select optimal grading standard [26]. Based on recently reports, different 842-07-9 chemical information research team presented different cut-off value for diagnosing significant fibrosis. Guha IN, et 12926553 al [27], Stabinski L. et al [28], and Fung J, et al [29], presented 8.8 kPa, 9.3 kPa, 8.1 kPa respectively as optimal cut-off value for diagnosing significant fibrosis ( F2). Since too higher cutoff value may be to lower the diagnostic sensitivity, we selected the relatively higher cut-off value, 8.8 kPa, for diagnosing significant fibrosis, in order to increase diagnostic specificity and accuracy. Difference of body constitution between east and west countries is other factor in our consideration, because liver stiffness variation in different populations [30]. Based onGP73, a Marker for Evaluating HBV ProgressionFigure 5. Gp73 recombinant protein prompted LX2 cells proliferation. A: when the concentration of GP73 recombinant protein was above 20 ng/ml, the LX2 proliferation was prompted. B: GP73 recombinant protein up-regulated collagen III 
expression, but collagen I was not. C: GP73 expression evaluated in different cells in vitro. doi:10.1371/journal.pone.0053862.gour present results, significant statistical differences only observed in several groups, although serum GP73 concentrations increasing with fibrosis progression. We speculated that these phenomena may be, at least in part, result in numbers of sample. Based on data of stiffness measurement, setting 76.6 ng/ml as cut-off value may be appropriate for significant fibrosis diagnosis in chronic hepatitis B population. The impressive finding of this study was a obvious difference in GP73 concentration in patients with different fibrotic grading, especially in patients with nearly normal ALT (Table 2). According to results of liver biopsy, 80.21 ng/ml and 85 ng/ml, may effectively differentiate significant fibrosis (S2) or 94-09-7 web moderate injury (G2) from mild fibrosis or injury respectively. Integrating all abovementioned results, we proposed that 85 ng/ml may be an appropriate cut-off value for diagnosing significant fibrosis of moderate/severe hepatocytes injury from patients with chronic HBV infections. If the cut-offTable 4. Effects of gp73 recombinant protein on LX2 cells.GP73 recombinant Protein (ng/ml)NOD value Mean ?SD 95 CI 0.86?.48 0.90?.54 1.04?.51 1.45?.73 1.64?.13 1.52?.value was set at 135 ng/ml, GP73 was also a potent marker for diagnosing liver cirrhosis. Although GP73 (tr/tr) mice (with a severe truncation of the GP73 C-terminus) developed marked abnormity in liver, the role of GP73 
in liver disease is still unknown [31]. The other interesting result is that GP73 may be not only a fibrosis marker, but also a contributor to fibrogenesis in patients with chronic HBV infections. Since unexplained high GP73 serum concentration was observed in patients with chronic HBV infection, this suggested that soluble GP73 may be playing a role in disease progression. This histological information indicated that non parenchym.Veniently used in clinical practice, especially in developing countries for differentiating significant fibrosis with mild fibrosis in patients with chronic hepatitis B. Liver stiffness is believed one of best non-invasive methods for evaluation liver fibrosis stage and disease progression. However, one question is what optimal cut-off value being chosen for fibrosis grading. Because numerous investigations provided different cut-off value for liver fibrosis classification, it was difficult to select optimal grading standard [26]. Based on recently reports, different research team presented different cut-off value for diagnosing significant fibrosis. Guha IN, et 12926553 al [27], Stabinski L. et al [28], and Fung J, et al [29], presented 8.8 kPa, 9.3 kPa, 8.1 kPa respectively as optimal cut-off value for diagnosing significant fibrosis ( F2). Since too higher cutoff value may be to lower the diagnostic sensitivity, we selected the relatively higher cut-off value, 8.8 kPa, for diagnosing significant fibrosis, in order to increase diagnostic specificity and accuracy. Difference of body constitution between east and west countries is other factor in our consideration, because liver stiffness variation in different populations [30]. Based onGP73, a Marker for Evaluating HBV ProgressionFigure 5. Gp73 recombinant protein prompted LX2 cells proliferation. A: when the concentration of GP73 recombinant protein was above 20 ng/ml, the LX2 proliferation was prompted. B: GP73 recombinant protein up-regulated collagen III expression, but collagen I was not. C: GP73 expression evaluated in different cells in vitro. doi:10.1371/journal.pone.0053862.gour present results, significant statistical differences only observed in several groups, although serum GP73 concentrations increasing with fibrosis progression. We speculated that these phenomena may be, at least in part, result in numbers of sample. Based on data of stiffness measurement, setting 76.6 ng/ml as cut-off value may be appropriate for significant fibrosis diagnosis in chronic hepatitis B population. The impressive finding of this study was a obvious difference in GP73 concentration in patients with different fibrotic grading, especially in patients with nearly normal ALT (Table 2). According to results of liver biopsy, 80.21 ng/ml and 85 ng/ml, may effectively differentiate significant fibrosis (S2) or moderate injury (G2) from mild fibrosis or injury respectively. Integrating all abovementioned results, we proposed that 85 ng/ml may be an appropriate cut-off value for diagnosing significant fibrosis of moderate/severe hepatocytes injury from patients with chronic HBV infections. If the cut-offTable 4. Effects of gp73 recombinant protein on LX2 cells.GP73 recombinant Protein (ng/ml)NOD value Mean ?SD 95 CI 0.86?.48 0.90?.54 1.04?.51 1.45?.73 1.64?.13 1.52?.value was set at 135 ng/ml, GP73 was also a potent marker for diagnosing liver cirrhosis. Although GP73 (tr/tr) mice (with a severe truncation of the GP73 C-terminus) developed marked abnormity in liver, the role of GP73 in liver disease is still unknown [31]. The other interesting result is that GP73 may be not only a fibrosis marker, but also a contributor to fibrogenesis in patients with chronic HBV infections. Since unexplained high GP73 serum concentration was observed in patients with chronic HBV infection, this suggested that soluble GP73 may be playing a role in disease progression. This histological information indicated that non parenchym.