高尔基体蛋白73(GP73)对慢性肝病的诊断价值
DOI: 10.3969/j.issn.1001-5256.2023.08.035
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摘要: 早期诊断并准确评估肝脏炎症和纤维化程度对慢性肝病的治疗干预及预后尤为重要。本文通过回顾高尔基体蛋白73(GP73)与肝癌、肝纤维化及肝脏炎症的诊断、预后方面的研究,归纳总结了目前GP73对于慢性肝病的诊断效能。分析表明除了与肝癌有关外,GP73与肝纤维化程度及预后密切相关,也可较好地反映肝脏炎症损伤。GP73与其他血清标志物联合,可提高慢性肝病的无创诊断效能。
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关键词:
- 肝疾病 /
- 高尔基体基质蛋白质类 /
- 诊断
Abstract: Early diagnosis and accurate assessment of liver inflammation and fibrosis is particularly important for the therapeutic intervention and prognosis of chronic liver diseases. This article summarizes the diagnostic efficacy of Golgi protein 73 (GP73) for chronic liver diseases by reviewing related clinical studies on GP73 and the diagnosis and prognosis of liver cancer, liver fibrosis, and liver inflammation. The analysis shows that besides liver cancer, GP73 is closely associated with the degree of liver fibrosis and prognosis and can better reflect liver inflammatory damage. GP73 combined with other serum markers can improve the noninvasive diagnosis of chronic liver diseases.-
Key words:
- Liver Diseases /
- Golgi Matrix Proteins /
- Diagnosis
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表 1 血清GP73用于HCC诊断的研究报道
Table 1. Clinical researches of serum GP73 for HCC diagnosis
第一作者 年份 研究对象 例数 GP73 敏感度(%) 特异度(%) 阳性预测值(%) 阴性预测值(%) AUC cut-off值 Marrero等[18] 2005 HCC vs 肝硬化 144 69.00 86.00 0.790 10个相对单位 Marrero等[18] 2005 早期HCC vs 肝硬化 69 62.00 88.00 0.770 10个相对单位 包永星等[21] 2013 早期HCC vs 肝硬化 40 72.50 70.40 0.749 178.2 μg/L Zhang等[25] 2015 AFP阴性的HCC 50 66.00 96.20 Mao等[20] 2010 HCC vs 非HCC 789 74.60 97.40 82.70 91.20 0.940 8.5个相对单位 Liu等[29] 2017 HCC vs 非肝硬化 1 102 0.834 HCC vs 肝硬化 1 102 0.613 有无肝硬化背景的HCC 197 0.527 Dong等[27] 2017 HCC vs 肝硬化 186 27.79 77.96 0.510 43.95 ng/mL Gatselis等[26] 2020 HCC vs 非HCC 130 56.00 59.00 26.00 83.00 0.623 20个相对单位 表 2 血清GP73用于肝纤维化与肝硬化诊断的研究报道
Table 2. Clinical researches of serum GP73 for the diagnosis of liver fibrosis and cirrhosis
第一作者 年份 研究对象 例数 GP73 敏感度(%) 特异度(%) 阳性预测值(%) 阴性预测值(%) AUC cut-off值 Gatselis等[26] 2020 肝硬化 450 59.00 95.00 0.909 20个单位 Xu等[34] 2015 肝硬化 250 79.20 80.00 0.830 138.20 ng/mL 失代偿期肝硬化 200 66.50 66.00 0.710 186.20 ng/mL 鲁凤民等[33] 2018 代偿期肝硬化 2 203 79.97 92.43 0.899 代偿性肝硬化 1 230 79.90 87.38 85.92 81.76 0.873 72.53 ng/mL CHB代偿期肝硬化 891 0.880 CHC代偿期肝硬化 446 0.926 AILD代偿期肝硬化 337 0.885 NAFLD代偿期肝硬化 143 0.962 其他原因代偿期肝硬化 386 0.935 病毒性肝炎肝纤维化(F≥2) 200 57.50 88.73 93.50 42.60 0.772 68.84 ng/mL AILD肝纤维化(F≥2) 143 74.13 92.00 98.10 38.30 0.855 54.33 ng/mL NAFLD肝纤维化(F≥2) 58 76.27 88.10 81.80 84.10 0.897 59.17 ng/mL 王鹏飞等[32] 2022 HCV代偿期肝硬化 145 84.92 91.03 0.923 73.56 ng/mL 表 3 血清GP73用于肝炎诊断的研究报道
Table 3. Clinical researches of serum GP73 for hepatic inflammation diagnosis
第一作者 年份 疾病类型 例数 GP73 敏感度(%) 特异度(%) 阳性预测值(%) 阴性预测值(%) AUC cut-off值 Wei等[35] 2019 CHB 220 43.59 97.18 0.806 85.7 ng/mL Yao等[30] 2019 CHB(ALT<40 U/L) 367 80.41 68.79 74.30 75.80 0.803 79.79 ng/mL 姚明解等[36] 2018 CHB(G≥2) 477 70.61 71.98 0.774 77.88 ng/mL 冯志刚等[37] 2015 酒精性肝病 119 71.40 95.20 90.40 83.90 Wang等[38] 2020 NASH(G≥2) 76 44.74 92.80 79.07 73.42 0.742 94.57 ng/mL Li等[39] 2021 NASH 46 0.830 Yao等[40] 2022 AIH(G≥2) 63 77.78 90.91 98.00 41.70 0.828 54.52 ng/mL PBC(G≥2) 78 74.36 75.00 93.50 37.50 0.797 48.19 ng/mL -
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