高尔基体蛋白73和透明质酸对HBV相关慢性肝病进展的诊断价值

张丽君; 刘明军; 王帅; 王麟; 王汝琨; 侯华斌; 孙桂荣; 张娜娜; 刘林杰

doi:10.3969/j.issn.1001-5256.2018.01.013

高尔基体蛋白73和透明质酸对HBV相关慢性肝病进展的诊断价值

DOI: 10.3969/j.issn.1001-5256.2018.01.013

1. 青岛大学附属医院检验科，山东省医药卫生重点实验室
2. 青岛市市立医院检验科

详细信息

中图分类号: R512.62
计量
- 文章访问数: 2710
- HTML全文浏览量: 43
- PDF下载量: 507
- 被引次数: 0
出版历程
- 出版日期: 2018-01-20

Clinical value of Golgi protein 73 and hyaluronic acid in diagnosis of the progression of hepatitis B virus-related chronic liver diseases

Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China

摘要

摘要: 目的探讨高尔基体蛋白73（GP73）与透明质酸（HA）在HBV相关慢性肝病进展中的临床应用价值。方法收集2016年12月-2017年4月就诊于青岛大学附属医院的患者142例,其中伴有肝硬化的肝细胞癌（HCC）36例（HCC组）,乙型肝炎肝硬化66例（肝硬化组）,慢性乙型肝炎（CHB）40例（CHB组）。另选取同一时期健康体检者30例作为对照。ELISA法检测血清中GP73浓度,化学发光法检测HA浓度。正态分布的计量资料多组间比较单因素方差分析;非正态分布的计量资料多组间比较采用Kruskal-Wallis H检验,进一步两两比较采用Mann-Whitney U检验。曲线分析比较GP73和HA单独或联合应用的临床诊断价值。受试者工作特征曲线下面积（AUC）比较采用Z检验,性别比、敏感度及特异度比较采用χ2检验。结果 CHB组、肝硬化组及HCC组患者血清GP73和HA水平均高于对照组（P值均<0.05）。肝硬化组、HCC组患者GP73和HA水平均明显高于CHB组（U值分别为677、637、291、193,P值均<0.05）。肝硬化组内比较,失代偿期患者GP...
- 高尔基体蛋白73 /
- 透明质酸 /
- 肝炎,乙型,慢性 /
- 肝硬化 /
- 癌,肝细胞 /
- 诊断
Abstract: Objective To investigate the clinical value of Golgi protein 73 ( GP73) and hyaluronic acid ( HA) in the diagnosis of the progression of hepatitis B virus ( HBV) -related chronic liver diseases. Methods A total of 142 patients who visited The Affiliated Hospital of Qingdao University from December 2016 to April 2017 were enrolled, and among these patients, 36 had hepatocellular carcinoma ( HCC) with liver cirrhosis, 66 had hepatitis B cirrhosis, and 40 had chronic hepatitis B ( CHB) . A total of 30 healthy subjects who underwent physical examination during the same period of time were enrolled as control group. ELISA was used to measure the serum level of GP73, and chemiluminescence was used to measure the level of HA. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Mann-Whitney U test was used for further comparison between any two groups. The receiver operating characteristic ( ROC) curve was used to analyze the diagnostic value of GP73 and HA measured alone or in combination. The Z test was used for comparison of area under the ROC curve ( AUC) , and the chi-square test was used for comparison of sex ratio, sensitivity, and specificity. Results The CHB group, liver cirrhosis group, and HCC group had significantly higher serum levels of GP73 and HA than the control group ( all P < 0. 05) . The liver cirrhosis group and the HCC group had significantly higher serum levels of GP73 and HA than the CHB group ( U = 677, 637, 291, and 193, all P < 0. 05) . In the liver cirrhosis group, the patients with decompensated liver cirrhosis had significantly higher serum levels of GP73 and HA than those with compensated liver cirrhosis ( U = 171 and 212, both P < 0. 05) . As for CHB patients, combined measurement of GP73 and HA had significantly higher AUC and sensitivity than GP73 measured alone ( AUC: 0. 950 vs 0. 790, Z = 2. 32, P < 0. 05; sensitivity: 91. 70% vs 72. 20% , χ2= 5. 14, P < 0. 05) . In the diagnosis of liver cirrhosis, GP73 had a significantly higher sensitivity than HA ( 87. 90% vs 69. 70% , χ2= 6. 05, P < 0. 05) , and compared with HA measured alone, combined measurement of GP73 and HA had a significant reduction in specificity ( 62. 30% vs 86. 80% , χ2= 14. 60, P < 0. 05) and a significant increase in sensitivity ( 93. 90% vs 69. 70% , χ2= 11. 80, P < 0. 05) . In the diagnosis of decompensated liver cirrhosis, combined measurement of GP73 and HA a significantly higher sensitivity than HA measured alone ( 83. 80% vs 67. 60% , χ2= 4. 17, P < 0. 05) . GP73, HA, and alpha-fetoprotein ( AFP) had an AUC of 0. 549, 0. 525, and 0. 807, respectively, in the diagnosis of HCC, and GP73 and HA had a lower diagnostic value than AFP ( Z = 3. 49 and 3. 80, both P < 0. 05) . Conclusion GP73 and HA can help with the monitoring of the progression of HBV-related chronic liver diseases. Combined measurement of GP73 and HA has an important clinical value in the diagnosis of liver cirrhosis and decompensated liver cirrhosis.
- Golgi protein 73 /
- hyaluronic acid /
- hepatitis B, chronic /
- liver cirrhosis /
- carcinoma, hepatocellular /
- diagnosis

HTML全文

参考文献(21)

[1]Mc MAHON BJ.Epidemiology and natural history of hepatitis B[J].Semin Liver Dis, 2005, 25 (Suppl 1) :3-8.

[2]YANG JD, KIM WR, COELHO R, et al.Cirrhosis is present in most patients with hepatitis B and hepatocellular carcinoma[J].Clin Gastroenterol Hepatol, 2011, 9 (1) :64-70.

[3]MARRERO JA, ROMANO PR, NIKOLAEVA O, et al.GP73, a resident Golgi glycoprotein, is a novel serum marker for hepatocellular carcinoma[J].J Hepatol, 2005, 43 (6) :1007-1012.

[4]LE P, GAO GS, DONG FB, et al.Serum Golgi protein 73 and 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, 2543. (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, 2543.

[5]XU Z, LIU L, PAN X, et al.Serum Golgi protein 73 (GP73) is a diagnostic and prognostic marker of chronic HBV liver disease[J].Medicine (Baltimore) , 2015, 94 (12) :e659.

[6]WU JW, WANG W, LIN SR.Change of hyaluronan and hyaluronan associated proteins in the development of chronic liver diseases and its significance[J].Lab Med Clin, 2013, 10 (7) :777-779. (in Chinese) 吴吉文, 王玮, 林寿榕.透明质酸及其相关蛋白在慢性肝病病程进展中的变化[J].检验医学与临床, 2013, 10 (7) :777-779.

[7]HUANG LG, REN Z, REN L, et al.Clinical value of combined detection of four serum indicators in chronic liver disease patients[J].Int J Lab Med, 2013, 34 (2) :167-168. (in Chinese) 黄连贵, 任重, 任力, 等.慢性肝病患者血清四项指标联合检测的临床价值[J].国际检验医学杂志, 2013, 34 (2) :167-168.

[8] National Health and Family Planning Commission of the People's Republic of China.Diagnosis, management, and treatment of hepatocellular carcinoma (V2017) [J].J Clin Hepatol, 2017, 33 (8) :1419-1431. (in Chinese) 中华人民共和国国家卫生和计划生育委员会.原发性肝癌诊疗规范 (2017年版) [J].临床肝胆病杂志, 2017, 33 (8) :1419-1431.

[9]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.

[10]CHEN Y, WANG BE, JIA JD, et al.Noninvasive evaluation of liver fibrosis in chronic hepatitis B patients[J].Chin J Hepatol, 2003, 11 (6) :354-357. (in Chinese) 陈煜, 王宝恩, 贾继东, 等.慢性乙型肝炎肝纤维化程度的无创性评估[J].中华肝脏病杂志, 2003, 11 (6) :354-357.

[11]KLADNEY RD, BULLA GA, GUO L, et al.GP73, a novel Golgi-localized protein upregulated by viral infection[J].Gene, 249 (1-2) :53-65.

[12]ZHANG XM, WEI MJ, XU ZJ, et al.Pattern of serumα-fetal protein, intereleukin-6 and Golgi protein 73 expressed in liver diseases and their diagnostic value on hepatocellular carcinoma[J/CD].Chin J Exp Clin Infect Dis:Electronic Version, 2017, 11 (4) :339-344. (in Chinese) 张小曼, 魏梅娟, 许正锯, 等.血清甲胎蛋白、白细胞介素-6和高尔基体蛋白73在肝脏疾病中的表达特点及其对肝细胞癌的诊断价值[J/CD].中华实验和临床感染病杂志:电子版, 2017, 11 (4) :339-344.

[13]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.

[14]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.

[15]SUZUKI A, ANGULO P, LYMP J, et al.Hyaluronic acid, an accurate serum marker for severe hepatic fibrosis in patients with non-alcoholic fatty liver disease[J].Liver Int, 2005, 25 (4) :779-786.

[16]ZHANG XD, LI WJ, GAO YN, et al.Diagnosis value of serum laminin and hyaluronic acid in liver fibrosis[J].China Med Herald, 2017, 14 (23) :111-113, 121. (in Chinese) 张新弟, 李卫娟, 高娅妮, 等.血清层粘连蛋白、透明质酸诊断肝纤维化的价值[J].中国医药导报, 2017, 14 (23) :111-113, 121.

[17]YAO JY, ZHONG BH, CHAO K, et al.Serological diagnosis of liver fibrosis[J].Chin J Gastroenterol Hepatol, 2011, 20 (8) :687-691. (in Chinese) 姚佳燕, 钟碧慧, 晁康, 等.肝纤维化血清学诊断的研究[J].胃肠病学和肝病学杂志, 2011, 20 (8) :687-691.

[18]TAN QW, GUO W, ZHANG CY, et al.Value of Golgi protein 73 (GP73) for diagnosis and grading of liver cirrhosis[J].J Diagn Concepts Pract, 2013, 12 (5) :516-521. (in Chinese) 谈绮文, 郭玮, 张春燕, 等.血清高尔基体蛋白73在肝硬化诊断及分级中的价值[J].诊断学理论与实践, 2013, 12 (5) :516-521.

[19]ZHANG WZ, TAO CH, LI Y.The changes and clinical value of serum Golgi protein 73 level in chronic HBV patient[J].Lab Med Clin, 2016, 13 (23) :3325-3328. (in Chinese) 张文昭, 陶才华, 李莹.乙肝患者血清高尔基蛋白73水平改变及其临床意义[J].检验医学与临床, 2016, 13 (23) :3325-3328.

[20]WANG CM, SUN L, ZHANG BW.Clinical profile and characteristics of serum GP73 in cirrhotic patients with chronic hepatitis B infections[J].Int J Lab Med, 2016, 37 (6) :765-766. (in Chinese) 王纯明, 孙莉, 张宝伟.乙型肝炎合并肝硬化患者血清GP73变化特征及临床意义[J].国际检验医学杂志, 2016, 37 (6) :765-766.

[21]LU FM.Serological diagnosis of hepatocellular carcinoma:challenges 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.

施引文献

资源附件(0)

访问统计