血清肝纤维化标志物区分具有正常或接近正常丙氨酸氨基转

StephenW

J Med Virol. 2018 Dec 10. doi: 10.1002/jmv.25364. [Epub ahead of print]
Serum liver fibrosis markers discriminate significant liver inflammation in chronic hepatitis B patients with normal or near-normal alanine aminotransferase.
Liao Y1, Gong J1, Zhou W1, Dong H1, Liang J1, Luo M1, Hu B1.
Author information

1
    Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

Abstract

Chronic liver inflammation caused by chronic hepatitis B virus (CHB) infection leads to liver cirrhosis and hepatocellular carcinoma. Recently, the role of alanine aminotransferase (ALT) as a predictor of liver inflammation has been questioned. The aim of this study was to investigate the utility of noninvasive fibrosis markers including hyaluronic acid (HA), collagen type IV (CIV), N-terminal propeptide of type III procollagen (PIIINP), and laminin (LN) in identifying significant liver inflammation in patients with CHB, especially in patients with normal or near-normal ALT. A total of 242 CHB patients who underwent liver biopsy were enrolled. The serum levels of ALT, aspartate aminotransferase, HA, CIV, PIIINP, and LN were quantified and the relationship between histological staging and serum markers was systematically analyzed. Serum CIV, PIIINP, HA, and LN levels increased significantly along with the increasing severity of liver inflammation. Multivariate analysis showed that CIV and LN were independently associated with significant inflammation. CIV, PIIINP, HA, and LN levels were found to have high diagnostic values for predicting significant inflammation in patients with CHB (area under the curve, AUC = 0.807, 0.795, 0.767, and 0.703, respectively). The combined index for the identification of significant inflammation, including CIV, PIIINP, HA, and LN levels, significantly improved diagnostic performance (AUC = 0.851). Moreover, the combined index also achieved excellent diagnostic accuracy (AUC = 0.861) in patients with CHB with normal or near-normal ALT. In conclusion, the combined index may be a strong indicator for discriminating significant liver inflammation, especially in patients with CHB with normal or near-normal ALT.
KEYWORDS:

hepatitis B virus; immunologic techniques; inflammation

PMID:
    30537157
DOI:
    10.1002/jmv.25364

StephenW

J Med Virol。 2018年12月10日doi：10.1002 / jmv.25364。 [提前打印]
血清肝纤维化标志物区分具有正常或接近正常丙氨酸氨基转移酶的慢性乙型肝炎患者的显着肝脏炎症。
廖Y1，龚J1，周W1，董H1，梁J1，罗M1，胡B1。
作者信息

1
    中山大学附属第三医院检验科，广州

抽象

慢性乙型肝炎病毒（CHB）感染引起的慢性肝脏炎症导致肝硬化和肝细胞癌。最近，丙氨酸氨基转移酶（ALT）作为肝脏炎症的预测因子的作用受到质疑。这项研究的目的是调查非侵入性纤维化标志物的效用，包括透明质酸（HA），IV型胶原蛋白（CIV），III型前胶原的N-末端前肽（PIIINP）和层粘连蛋白（LN）在鉴别显着的肝脏炎症在CHB患者中，尤其是ALT正常或接近正常的患者。共招募了242名接受肝脏活检的CHB患者。定量分析ALT，天冬氨酸氨基转移酶，HA，CIV，PIIINP和LN的血清水平，系统分析组织学分期与血清标志物之间的关系。随着肝脏炎症严重程度的增加，血清CIV，PIIINP，HA和LN水平显着增加。多变量分析显示CIV和LN与显着的炎症独立相关。发现CIV，PIIINP，HA和LN水平具有高诊断值，用于预测CHB患者的显着炎症（曲线下面积，AUC分别为0.807,0.795,0.767和0.703）。用于鉴定显着炎症（包括CIV，PIIINP，HA和LN水平）的组合指数显着改善了诊断性能（AUC = 0.851）。此外，综合指数在ALT正常或接近正常的CHB患者中也获得了极好的诊断准确性（AUC = 0.861）。总之，联合指数可能是区分显着肝脏炎症的强有力指标，特别是对于ALT正常或接近正常的CHB患者。
关键词：

乙型肝炎病毒;免疫技术;炎

结论：
    30537157
DOI：
    10.1002 / jmv.25364