血清高尔基体蛋白73在辅助诊断慢性乙型肝炎患者中度以上肝损伤中的应用

姚明解; 王雷婕; 关贵文; 席婧媛; 刘树红; 文夏杰; 邹军; 陈香梅; 贾继东; 赵景民; 鲁凤民

doi:10.3969/j.issn.1001-5256.2018.04.012

血清高尔基体蛋白73在辅助诊断慢性乙型肝炎患者中度以上肝损伤中的应用

DOI: 10.3969/j.issn.1001-5256.2018.04.012

1. 北京大学基础医学院病原生物学系暨感染病中心
2. 中国人民解放军第三〇二医院病理诊断与研究中心
3. 首都医科大学附属北京友谊医院肝病中心

基金项目:

国家十三五"艾滋病和病毒性肝炎等重大传染病防治"科技重大专项基金资助项目(2017ZX10302201,2017ZX10202203)；国家自然科学基金资助项目(81372603,81471938)；中国博士后科学基金(2017M620544)；北京市科学技术委员会资助项目(Z161100000116047,D161100002716003)；

详细信息

中图分类号: R512.62
计量
- 文章访问数: 2825
- HTML全文浏览量: 17
- PDF下载量: 456
- 被引次数: 0
出版历程
- 收稿日期: 2017-10-17
- 出版日期: 2018-04-20

Value of serum Golgi protein 73 in assisting the diagnosis of moderate or severe liver injury in patients with chronic hepatitis B

Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center

Research funding:

摘要

摘要: 目的评价血清标志物高尔基体蛋白73（GP73）对慢性乙型肝炎患者肝组织炎症活动度与纤维化程度的诊断价值。方法回顾性收集2013年12月-2017年5月就诊于中国人民解放军第三〇二医院行肝穿刺检查的678例慢性乙型肝炎患者的血清,并随机分为2组（A组477例,B组201例）,使用ELISA试剂盒,依照说明书进行血清GP73的定量检测。2独立样本间比较采用Mann-Whitny U检验,相关性比较使用Spearman相关性分析,定性资料组间比较采用χ2检验。结果血清GP73在A组与B组患者中均随着肝组织炎症活动度与纤维化程度的加重而升高,在A组患者中血清GP73与肝脏炎症活动度及纤维化程度均显著相关（r值分别为0.529、0.434,P值均<0.001）,在B组患者中也得到了类似的结果（r值分别为0.418、0.437,P值均<0.001）。血清GP73诊断肝脏中度及以上炎症坏死（G≥2）及重度及以上炎症坏死（G≥3）的受试者工作特征曲线下面积,A组患者分别为0.774[95%可信区间（95%CI）:0.7330.811,P<0.001)和0.844...
- 肝炎,乙型,慢性 /
- 高尔基体蛋白73 /
- 丙氨酸转氨酶 /
- 诊断
Abstract: Objective To investigate the value of Golgi protein 73 (GP73) in the diagnosis of liver inflammatory activity and fibrosis degree in chronic hepatitis B (CHB) patients.Methods Serum samples were collected from 678 patients who underwent liver biopsy in 302 Hospital of PLA from December 2013 to May 2017, and the patients were randomly divided into group A with 477 patients and group B with 201 patients.A double-antibody sandwich ELISA kit was used to measure the serum level of GP73 according to instructions.The Mann-Whitney U test was used for the comparison of two independent samples, the Spearman correlation analysis was used to investigate correlation, and the chi-square test was used for comparison of categorical data between groups.Results The serum level of GP73 increased with increasing liver inflammatory activity and fibrosis degree in both groups; in group A, the serum level of GP73 was significantly correlated with liver inflammatory activity and fibrosis degree (r = 0.529 and 0.434, both P < 0.001) , and a similar result was obtained in group B (r =0.418 and 0.437, both P < 0.001) .The areas under the receiver operating characteristic curve of serum GP73 to diagnose G≥2 liver inflammation and necrosis and G≥3 inflammation and necrosis were 0.774 (95% confidence interval [CI]:0.733-0.811, P < 0.001) and0.844 (95% CI:0.808-0.875, P < 0.001) in group A and 0.730 (95% CI:0.663-0.790, P < 0.001) and 0.716 (95% CI:0.649-0.777, P < 0.001) in group B.With the help of alanine aminotransferase (ALT) combined with serum GP73, 77.4% of the patients in group A and 78.9% of the patients in group B were found to have G≥2 and/or S≥2 disease.Conclusion Serum GP73 can be used in combination with ALT to identify the CHB patients that need antiviral therapy and thus reduce the dependence on liver biopsy.
- hepatitis B, chronic /
- Golgi protein 73 /
- alanine transaminase /
- diagnosis

HTML全文

参考文献(22)

[1]GANEM D, PRINCE AM.Hepatitis B virus infection-natural history and clinical consequences[J].N Engl J Med, 2004, 350 (11) :1118-1129.

[2]European Association for the Study of the Liver.EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection[J].J Hepatol, 2017, 67 (2) :370-398.

[3]NGUYEN K, PAN C, XIA V, et al.Clinical course of chronic hepatitis B (CHB) presented with normal ALT in Asian American patients[J].J Viral Hepat, 2015, 22 (10) :809-816.

[4]LESMANA CR, GANI RA, HASAN I, et al.Significant hepatic histopathology in chronic hepatitis B patients with serum ALT less than twice ULN and high HBV-DNA levels in Indonesia[J].J Dig Dis, 2011, 12 (6) :476-480.

[5]GOBELT, ERHARDT A, HERWIG M, et al.High prevalence of significant liver fibrosis and cirrhosis in chronic hepatitis B patients with normal ALT in central Europe[J].J Med Virol, 2011, 83 (6) :968-973.

[6]NGUYEN MH, GARCIA RT, TRINH HN, et al.Histological disease in Asian-Americans with chronic hepatitis B, high hepatitis B virus DNA, and normal alanine aminotransferase levels[J].Am J Gastroenterol, 2009, 104 (9) :2206-2213.

[7]SARIN SK, KUMAR M.Should chronic HBV infected patients with normal ALT treated:debate[J].Hepatol Int, 2008, 2 (2) :179-184.

[8]European Association for the Study of the Liver.EASL clinical practice guidelines:management of chronic hepatitis B virus infection[J].J Hepatol, 2012, 57 (1) :167-185.

[9]European Association for Study of Liver;Asociación Latinoamericana para el Estudio del Hígado.EASL-ALEH Clinical Practice Guidelines:non-invasive tests for evaluation of liver disease severity and prognosis[J].J Hepatol, 2015, 63 (1) :237-264.

[10]MAO Y, YANG H, XU H, et al.Golgi protein 73 (GOLPH2) is a valuable serum marker for hepatocellular carcinoma[J].Gut, 2010, 59 (12) :1687-1693.

[11]HOU SC, XIAO MB, NI RZ, et al.Serum GP73 is complementary to AFP and GGT-II for the diagnosis of hepatocellular carcinoma[J].Oncol Lett, 2013, 6 (4) :1152-1158.

[12]QIAO Y, CHEN J, LI X, et al.Serum gp73 is also a biomarker for diagnosing cirrhosis in population with chronic HBV infection[J].Clin Biochem, 2014, 47 (16-17) :216-222.

[13]WEI H, LI B, ZHANG R, et al.Serum GP73, a marker for evaluating progression in patients with chronic HBV infections[J].PLo S One, 2013, 8 (2) :e53862.

[14]LIU T, YAO M, LIU S, et al.Serum Golgi protein 73 is not a suitable diagnostic marker for hepatocellular carcinoma[J].Oncotarget, 2017, 8 (10) :16498-16506.

[15]LU FM.Serological diagnosis of hepatocelllulat carcinoma:challenge and opportunities[J].J Clin Hepatol, 2017, 33 (7) :1262-1265. (in Chinese) 鲁凤民.肝细胞癌的血清学诊断——挑战与希望同在[J].临床肝胆病杂志, 2017, 33 (7) :1262-1265.

[16]Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B:a 2015 update[J].J Clin Hepatol, 2015, 31 (12) :1941-1960. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南 (2015年更新版) [J].临床肝胆病杂志, 2015, 31 (12) :1941-1960.

[17]LE P, GAO GS, DONG FB, et al.Serum Golgi protein 73and three noninvasive serum score systems for diagnosis of liver fibrosis in patients with chronic hepatitis B[J].Chin J Nosocomiol, 2016, 26 (11) :2529-2531. (in Chinese) 乐萍, 高国生, 董飞波, 等.血清高尔基体蛋白73及3种评分系统对慢性乙型肝炎患者肝纤维化的预测价值研究[J].中华医院感染学杂志, 2016, 26 (11) :2529-2531.

[18]ZHENG JJ, QIAN QX, WANS SL, et al.The relationship between liver fibrosis and GP73 in the patients with chronic hepatitis B[J].Chin J Health Lab Technol, 2012, 22 (2) :247-248. (in Chinese) 郑建建, 钱琼信, 王斯璐, 等.慢性乙型肝炎患者血清GP73与肝纤维化的相关性[J].中国卫生检验杂志, 2012, 22 (2) :247-248.

[19]CAO Z, LI Z, WANG H, et al.Algorithm of Golgi protein 73 and liver stiffness accurately diagnoses significant fibrosis in chronic HBV infection[J].Liver Int, 2017, 37 (11) :1612-1621.

[20]FARCI P, WOLLENBERG K, DIAZ G, et al.Profibrogenic chemokines and viral evolution predict rapid progression of hepatitis C to cirrhosis[J].Proc Natl Acad Sci U S A, 2012, 109 (36) :14562-14567.

[21]LUO KX, CHEN JJ, LI P.Hepatitis B basic biology and clinical science[M].Beijing:People's Medical Publishing House, 1997:397. (in Chinese) 骆抗先, 陈金军, 李平.乙型肝炎基础与临床[M].北京:人民卫生出版社, 1997:397.

[22]IFTIKHAR R, KLADNEY RD, HAVLIOGLU N, et al.Diseaseand cell-specific expression of GP73 in human liver disease[J].Am J Gastroenterol, 2004, 99 (6) :1087-1095.

施引文献

资源附件(0)

访问统计