乙肝患者血清高尔基蛋白73水平改变及其临床意义

乙肝患者血清高尔基蛋白73水平改变及其临床意义
张文昭;陶才华;李莹
【期刊名称】《检验医学与临床》
【年(卷),期】2016(013)023
【摘要】Objective To explore the changes and clinical value of serum Golgi protein (GP)73 level in chronic HBV patient . Methods Three‐hundred chronic HBV patients from January 2013 to June 2015 in hospital were enrolled in this study and divided into four group based on clinical
status :HBV‐C group(n=50) ,CHB group(n=120) ,LC group(n=60) and HCC group(n=70) . The levels of GP73 in each group were compared by using correlation analysis and ROC curve analysis .Results The levels of GP 73 in HBV‐C group were significantly lower than those in CHB group ,HCC group and LC group[(117 .3 ± 12 .8) ng/mL ,(181 .5 ± 21 .7) ng/mL ,(263 .2 ± 33 .4) ng/mL vs .(39 .2 ± 3 .5) ng/mL ,P<0 .05] .The conten ts of CHB group were significantly lower than those in HCC group and LC group[(181 .5 ±
21 .7)ng/mL ,(263 .2 ± 33 .4)ng/mL vs .(117 .3 ± 12 .8) ng/mL ,P<0 .05] .The patients with compensatory LC had a lower serum GP 73 compared with de‐compensatory patients [(245 .6 ± 29 .3)ng/mL vs . (279 .5 ±
39 .6)ng/mL ,P<0 .05] .Correlation analysis showed that serum GP73 were positively associated with AST (r= 0 .554 ,
P<0 .05) ,ALT(r=0 .409 ,P<0 .05) ,albumin(r=0 .445 ,P<0 .05) ,Child‐pugh grade(r=0 .609 ,P<0 .05) an d de‐compensatory LC(r=0 .722 ,P<0 .05) .ROC
analysis suggested that AUC of GP73 for CHB was 0 .741 ,95% CI:0 .519-
0 .813 ,cut off value was 176 .3 ng/mL ,the sensitivity was 77 .8% ,specificity was 77 .2% ;AUC of GP73 for HCC was 0 .749 ,95% CI:0 .676 -0 .834 ,cut off value was 232 .0 ng/mL ,the sensitivity was 78 .0% ,specificity was
82 .5% ;AUC of GP73 for LC was 0 .738 ,95% CI:0 .636 -0 .841 ,cut off value was 292 .2 ng/mL ,the sensitivity was 74 .4% ,specificity was 80 .9% .AUC of GP73 for the loss of compensa‐tory LC was 0 .802 ,95% CI:for the 0 .699-
0 .932 ,off cut value was 319 .3 ng/mL ,the sensitivity was 84 .2% ,the specificity was 90 .3% .Conclusion GP73 can be used as a sensitive and specific liver marker ,not only to help early diagnosis of HCC and LC ,but also help to judge the state of liver function in patients with LC .%目的：探讨乙肝患者血清高尔基蛋白（G P ）73水平改变及其临床意义。

方法连续性纳入2013年1月至2015年6月于镇江市中西医结合医院就诊的300例慢性乙肝病毒感染患者，根据病情分为乙肝病毒携带（HBV‐C ）组共50例，慢性乙肝（CHB）组共120例，乙肝相关肝硬化（LC）组共60例，乙肝相关肝细胞癌（HCC）组
70例。

比较各组之间血清GP73水平差异，并通过相关性分析和受试者工作特征
曲线（ROC曲线）分析比较GP73对不同乙肝患者病变程度的诊断学价值。

结果CHB组、HCC组和LC组患者GP73水平分别为（117．3±12．8）、（181．5±21．7）、（263．2±33．4）ng／mL ，均明显高于HBV‐C组患者
的（39．2±3．5）ng／mL ，差异均有统计学意义（P＜0．05）。

HCC组和LC 组患者GP73水平又明显高于CHB组，差异有统计学意义（P＜0．05）。

代偿
LC亚组GP73水平[（245．6±29．3）ng／mL]明显低于失代偿LC亚组[（279．5±39．6）ng／mL]，差异有统计学意义（ P＜0．05）。

血清G P73
水平与天门冬氨酸氨基转移酶（ r＝0．554，P＜0．05）、丙氨酸氨基转移酶
（ r＝0．409，P＜0．05）、清蛋白（r＝0．445，P＜0．05）、Child‐pugh
分级（r＝0．609，P＜0．05）和失代偿LC（r＝0．722，P＜0．05）呈正相关。

GP73对于CHB的ROC曲线下面积（AUC）为0．741，95％ CI为0．519～0．813，cut off值为176．3 ng／mL ，敏感性为77．8％，特异性为77．2％；GP73对于HCC的AUC为0．749，95％ CI为0．676～0．834，cut off值为232．0 ng／mL ，敏感性为78．0％，特异性为82．5％；GP73对于LC的AUC为0．738，95％ CI为0．636～0．841，cut off值为292．2 ng／mL ，敏感性为74．4％，特异性为80．9％；GP73对于失代偿性LC的AUC为0．802，95％ CI为0．699～0．932，cut off值为319．3 ng／mL ，敏感性
为84．2％，特异性为90．3％。

结论 GP73可以作为一种较为敏感且特异性较
高的肝脏标记物，不但有助于早期诊断 HCC和LC ，还有助于辅助判断LC患者
肝功能代偿状态。

【总页数】4页(P3325-3328)
【作者】张文昭;陶才华;李莹
【作者单位】江苏省镇江市中西医结合医院检验科 212004;江苏省镇江市第一人
民医院检验科 212000;江苏省镇江市中西医结合医院检验科 212004
【正文语种】中文
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