摘要
目的分析血清乙型肝炎病毒(hepatitis B virus,HBV)前S1蛋白(precursor S1 protein,preS1)与慢性乙型肝炎(chronic hepatitis B,CHB)肝纤维化及癌变进展的相关性。方法对2019年10月—2021年10月期间在青海红十字医院接受检查的228例乙肝表面抗原(hepatitis B surface antigen,HBsAg)阳性慢性HBV感染者进行回顾性分析,其中CHB患者75例、肝硬化(liver cirrhosis,LC)患者93例(LC组)、肝细胞癌(hepatocellular carcinoma,HCC)患者60例(HCC组)。根据LC和HCC组肝组织活检分析肝脏炎症活动及肝纤维化程度。结果HCC组血清preS1水平[496.32(457.63,988.0)ng/mL]和LC组[338.72(247.93,554.61)ng/mL]血清preS1水平均显著高于CHB组[113.69(87.09,177.40)ng/mL],且差异具有统计学意义(P均<0.05)。HCC组血清preS1水平亦高于LC组(P=0.002)。经受试者工作特征曲线分析,血清preS1水平鉴别诊断CHB与LC的曲线下面积(area under the curve,AUC)是0.881(95%CI:0.830~0.932),鉴别诊断CHB/LC与HCC的AUC是0.861(95%CI:0.815~0.908)。3组患者的血清preS1水平与HBsAg(rs=0.799,P<0.001)呈强正相关和Log HBV DNA(rs=0.262,P<0.001)呈弱正相关。此外LC组和HCC组血清preS1水平与肝脏炎症活动分级(rs=0.201,P=0.009)及肝纤维化分期也呈弱正相关性(rs=0.295,P<0.001)。结论血清preS1水平与血清HBsAg、HBV DNA水平和肝脏炎症和纤维化进展呈正相关,有可能成为鉴别诊断HBV相关慢性肝病肝硬化或癌变的候选标志物。
Objective To analyze the correlation between serum hepatitis B virus(HBV)precursor S1 protein(preS1)and liver fibrosis and disease progression in chronic hepatitis B(CHB).Methods A total of 228 patients with hepatitis B surface antigen(HBsAg)positive chronic HBV infection examined in our hospital from October 2019 to October 2021 were analyzed retrospectively,including 73 patients with CHB,93 patients with liver cirrhosis(LC),60 patients with hepatocellular carcinoma(HCC).Liver fibrosis and inflammatory activity was analyzed by liver biopsy.Results Serum preS1 level in HCC group[496.32(457.63,988.0)ng/mL]and LC group[338.72(247.93,554.61)ng/mL]were significantly higher than those in CHB group[113.69(87.09,177.40)ng/mL](P<0.001).The serum preS1 level in HCC group was also higher than that in LC group(P=0.002).According to receiver operating characteristic curve analysis,the area under the curve of serum preS1 level to differential d iagnosis LC vs.CHB group or HCC vs.LC+CHB group was 0.881(95%CI:0.830~0.932)and 0.861(95%CI:0.815~0.908),respectively.Serum preS1 level were strongly positively correlated with HBsAg(rs=0.799,P<0.001)and weakly positively correlated with Log HBV DNA(rs=0.262,P<0.001)in patients with CHB,LC and HCC.Additionally,serum preS1 level was also weakly positively correlated with liver inflammatory activity grade(rs=0.201,P=0.009)and liver fibrosis stage(rs=0.295,P<0.001)in LC group and HCC group.Conclusion The serum preS1 level is correlated with the levels of HBV markers in the serum HBsAg and HBV DNA levels,as well as the progression of liver inflammation and fibrosis.Therefore,it has the potential to serve as a valuable biomarker for distinguishing between cirrhosis and canceration in patients with HBV-associated chronic liver disease.
作者
高兴娟
程磊
马秀清
刘守珠
王宝英
刘海燕
才德吉
杨兴唐
GAO Xingjuan;CHENG Lei;MA Xiuqing;LIU Shouzhu;WANG Baoying;LIU Haiyan;CAI Deji;YANG Xingtang(Department of Clinical Laboratory,Qinghai Red Cross Hospital,Xining 810001,China)
出处
《传染病信息》
2024年第2期132-136,共5页
Infectious Disease Information
基金
青海省科技厅指导性计划项目(2022-ZJ-766)。
关键词
乙型肝炎病毒
HBV前S1蛋白
慢性乙型肝炎
肝纤维化
肝硬化
肝细胞癌
hepatitis B virus
HBV pre-S1 protein
chronic hepatitis b
liver fibrosis
liver inflammatory activity
hepatocellular carcinoma