Association between γ-glutamyl transpeptidase-to-platelet ratio and hepatic fibrosis in patients with chronic hepatitis B
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摘要: 早期、准确地诊断肝纤维化并给予抗病毒治疗是改善慢性乙型肝炎预后的关键。肝活组织检查及瞬时弹性成像技术诊断肝纤维化难以在临床普遍使用,因而血清学诊断模型成为近年的研究热点。介绍了一种新的肝纤维化血清学诊断模型GGT与PLT比值指数(GPR),其对慢性乙型肝炎肝纤维化的诊断价值较高,但GPR在不同人群、不同地区诊断的准确性存在差异。GPR也是慢性乙型肝炎相关肝细胞癌预后的良好预测指标。认为GPR用于慢性乙型肝炎肝纤维化的诊断有良好前景,但因GPR临床研究数据较少,故在我国推广应用尚需进一步的研究证实。Abstract: Early and accurate diagnosis of hepatic fibrosis and application of antiviral therapy are the key to improving the prognosis of patients with chronic hepatitis B (CHB) .Liver biopsy and transient elastography cannot be widely used for the diagnosis of hepatic fibrosis in clinical practice, and therefore, the serological diagnostic model has become a hot research topic in recent years.This article introduces a new serological diagnostic model, γ-glutamyl transpeptidase-to-platelet ratio (GPR) , which has a high value in the diagnosis of hepatic fibrosis in CHB patients;however, the accuracy of GPR varies between different populations and different areas.GPR is also an excellent predictor for the prognosis of hepatitis B-associated liver cancer.It is pointed out that GPR has a promising future in the diagnosis of hepatic fibrosis in CHB patients, but due to a lack of clinical research data on GPR, further studies are needed to support its application in China.
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Key words:
- hepatitis B /
- chronic /
- liver cirrhosis /
- gamma-glutamyltransferase /
- blood platelets
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[1]SUN YT, ZHANG YX, TANG H, et al.Clinical characteristics and current management of hepatitis B and C in China[J].World JGastroenterol, 2014, 20 (37) :13582-13590. [2]CHAN SL, WONG VWS, QIN SK, et al.Infection and cancer:the case of hepatitis B[J].J Clin Oncol, 2016, 34 (1) :83-90. [3]Chinese Society of Hepatology, Chinese Medical Association;Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B:a 2015 update[J].JClin 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更新版) [J].临床肝胆病杂志, 2015, 31 (12) :1941-1960. [4]WANG H, XUE L, YAN R, et al.Comparison of histologic characteristics of Chinese chronic hepatitis B patients with persistently normal or mildly elevated ALT[J].PLoS One, 2013, 8 (11) :e80585. [5] SARIN SK, KUMAR M, LAU GK, et al.Asian-Pacific clinical practice guidelines on the management of hepatitis B:a 2015 update[J].Hepatol Int, 2016, 10 (1) :1-98. [6]TERRAULT NA, BZOWEJ NH, CHANG KM, et al.AASLDguidelines for treatment of chronic hepatitis B[J].Hepatology, 2016, 63 (1) :261-283. [7]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. [8]LI Q, LI W, HUANG Y, et al.The gamma-glutamyl transpeptidase-to-platelet ratio predicts liver fibrosis and cirrhosis in HBeA g-positive chronic HBV infection patients with high HBV DNA and normal or mildly elevated alanine transaminase levels in China[J].J Viral Hepat, 2016, 23 (11) :912-919. [9]LEMOINE M, SHIMAKAWA Y, NAYAGAM S, et al.The gammaglutamyl transpeptidase to platelet ratio (GPR) predicts significant liver fibrosis and cirrhosis in patients with chronic HBV infection in West Africa[J].Gut, 2016, 65 (8) :1369-1376. [10]GERAID K, STEPHANIE S.Gamma-glutamyl transferase:a predictive biomarker of cellular antioxidant inadequacy and disease risk[J].Dis Markers, 2015, 2015:818570. [11]EMINLER AT, IRAK K, AYYILDIZ T, et al.The relation between liver histopathology and GGT levels in viral hepatitis:More important in hepatitis B[J].Turk J Gastroenterol, 2014, 25 (4) :411-415. [12]XIAN YC, YANG JY, XU R, et al.Clinical significance of serum glutamyl transpeptidase in chronic hepatitis B[J].Chin J Exp Clin Virol, 2007, 21 (4) :383-385. (in Chinese) 冼永超, 杨景毅, 徐茹, 等.血清谷氨酰转肽酶含量测定在慢性乙型肝炎中的临床意义[J].中华实验和临床病毒学杂志, 2007, 21 (4) :383-385. [13]PANG Q, BI JB, WANG ZX, et al.Simple models based on gamma-glutamyl transpeptidase and platelets for predicting survival in hepatitis B-associated hepatocellular carcinoma[J].Onco Targets Ther, 2016, 9:2099-2109. [14]TAO S, WANG SL, WU Q, et al.Application of area percentage share of blue region in ultrasonic elastog-raphy in evaluating hepatitis B virus-related liver fibrosis grading[J].China Med Herald, 2015, 12 (19) :102-105. (in Chinese) 陶山, 王少璐, 吴强, 等.弹性超声蓝色面积百分比在乙肝纤维化分级中的应用研究[J].中国医药导报, 2015, 12 (19) :102-105. [15]LI J, GORDON SC, RUPP LB, et al.The validity of serum markers for fibrosis staging in chronic hepatitis B and C[J].J Viral Hepat, 2014, 21 (12) :930-937. [16]SURAJ S, KOROSH K, GEOFFREY CN.Non-invasive diagnosis of advanced fibrosis and cirrhosis[J].World J Gastroenterol, 2014, 20 (45) :16820-16830. [17]SHI KQ, FAN YC, PAN ZZ, et al.Transient elastography:a meta-analysis of diagnostic accuracy in evaluation of portal hypertension in chronic liver disease[J].Liver Int, 2013, 33 (1) :62-71. [18]ZENG XH, XU C, HE DM, et al.Performance of several simple, noninvasive models for assessing significant liver fibrosis in patients with chronic hepatitis B[J].Croat Med J, 2015, 56 (3) :272-279. [19]DAI MJ, LENG XJ, YAN XB.Interpretation of 2015 WHO guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection:comparison antiviral treatment of chronic hepatitis B[J].J Clin Hepatol, 2015, 31 (7) :1004-1007. (in Chinese) 戴明佳, 冷雪君, 颜学兵.《2015年世界卫生组织慢性乙型肝炎病毒感染预防、关怀和治疗指南》解读:慢性乙型肝炎的抗病毒治疗策略比较[J].临床肝胆病杂志, 2015, 31 (7) :1004-1007. [20]LIAW YF, KAO JH, PIRATVISUTH T, et al.Asian-Pacific consensus statement on the management of chronic hepatitis B:a 2012update[J].Hepatol Int, 2012, 6 (3) :531-561. [21]BOYD A, BOTTERO J, LACOMBE K.The gamma-glutamyl transpeptidase-to-platelet ratio as a predictor of liver fibrosis in patients co-infected with HBV and HIV[J].Gut, 2016, 65 (4) :718-720. [22]STOCKDALE AJ, PHILLIPS RO, GERETTI AM.The gamma-glutamyl transpep-tidase to platelet ratio (GPR) shows poor correlation with transient elastography measurements of liver fibrosis in HIV-positive patients with chronic hepatitis B in West Africa.Response to:‘The gamma-glutamyl transpeptidase to platelet ratio (GPR) predicts significant liver fibrosis and cirrhosis in patients with chronic HBV infection in West Africa’by Lemoine et al[J].Gut, 2016, 65 (5) :882-884. [23]TREPO C, CHAN HLY, LOK A.Hepatitis B virus infection[J].Lancet, 2014, 384 (9959) :2053-2063. [24]JUN CH, HONG HJ, CHUNG MW, et al.Risk factors for hepatocellular carcinoma in patients with drug-resistant chronic hepatitis B[J].World J Gastroenterol, 2013, 19 (40) :6834-6841. [25]LIN YJ, LEE MH, YANG HI, et al.Predictability of liver-related seromarkers for the risk of hepatocellular carcinoma in chronic hepatitis B patients[J].PLoS One, 2013, 8 (4) :e61448. [26]PANG Q, BI JB, XU XS, et al.King's score as a novel prognostic model for patients with hepatitis Bassociated hepatocellular carcinoma[J].Eur J Gastroenterol Hepatol, 2015, 27 (11) :1337-1346. [27]WANG LW, ZHENG XL, ZHANG ZY, et al.Preoperativeγ-glutamyl transpeptidase to platelet ratio (GPR) is an independent prognostic factor for HBV-related hepatocellular carcinoma after curative hepatic resection[J].Medicine, 2016, 95 (27) :4087-4093. [28]TANG QR, HE Q, TANG QY.Research advances in non-invasive diagnosis models for liver fibrosis in chronic hepatitis B[J].JClin Hepatol, 2015, 31 (8) :1355-1359. (in Chinese) 唐情容, 何清, 唐奇远.慢性乙型肝炎肝纤维化无创性诊断模型的研究进展[J].临床肝胆病杂志, 2015, 31 (8) :1355-1359.
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