γ-谷氨酰轉移酶和丙氨酸轉氨酶比，甲胎蛋白以及維生素K缺

StephenW

Diagnostic value of the γ-glutamyltransferase and alanine transaminase ratio, alpha-fetoprotein, and protein induced by vitamin K absence or antagonist II in hepatitis B virus-related hepatocellular carcinoma
Guangrong Wang  1   2   3 , Xiaolan Lu  1   2 , Qin Du  1   2 , Guoyuan Zhang  1   2 , Dongsheng Wang  1   3 , Qiang Wang  4   5   6 , Xiaolan Guo  7   8   9
Affiliations
Affiliations

    1
    Department of Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.
    2
    Faculty of Laboratory Medicine, Center for Translational Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.
    3
    Department of Laboratory Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.
    4
    Department of Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China. [email protected].
    5
    Faculty of Laboratory Medicine, Center for Translational Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China. [email protected].
    6
    Department of Laboratory Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China. [email protected].
    7
    Department of Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China. [email protected].
    8
    Faculty of Laboratory Medicine, Center for Translational Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China. [email protected].
    9
    Department of Laboratory Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China. [email protected].

    PMID: 32782270 DOI: 10.1038/s41598-020-70241-5

Abstract

Hepatocellular carcinoma is a common type of malignancy with a poor prognosis. Identification and utilisation of markers for monitoring and diagnosis are urgently needed. Alpha-fetoprotein (AFP) and Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) have been proved to be efficient biomarkers for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). The combination of the two markers could improve the detection rate. However, these indicators cannot meet the need of clinical diagnosis.It is necessary to discover novel serological markers and more cost-effective, appropriate combination of these markers for the diagnosis and surveillance of HBV-related HCC. Accordingly, in this study, we aimed to evaluate the diagnostic value of γ-glutamyltransferase (γ-GT) to alanine amino transferase (ALT) ratio alone or in combination with AFP and PIVKA-II for HBV-related HCC. 234 patients with HBV-related HCC and 396 patients with chronic hepatitis B (CHB) were enrolled in this study and approved by the institutional review board. Our results showed levels of AFP and PIVKA-II, and γ-GT/ALT ratio in cases with early-stage HCC, HCC, HCC plus HBV DNA positivity, and HCC plus HBV DNA negativity were higher than those in the corresponding CHB control group. Additionally, the levels of serum AFP and PIVKA-II, and the γ-GT/ALT ratio were positively correlated with tumour sizes in patients with HBV-related HCC. The areas under the ROC curves (AUROCs) of the γ-GT/ALT ratio in patients with early-stage HCC, HCC, HCC plus HBV DNA positivity, and HCC plus HBV DNA negativity were 0.795, 0.846,0.855, and 0.837, respectively; AUROCs of combination of the γ-GT/ALT ratio and PIVKA-II were 0.858, 0.928, 0.948, and 0.902, respectively; AUROCs of combination of the γ-GT/ALT ratio and AFP were 0.822, 0.886, 0.896, and 0.873, respectively;AUROCs of combination of the γ-GT/ALT ratio and PIVKA-II with AFP were 0.857, 0.928, 0.946, and 0.907, respectively, and AUROCs of combination of PIVKA-II and AFP were 0.804, 0.904, 0.942, and 0.863, respectively. In conclusion, the γ-GT/ALT ratio was a useful biomarker for the diagnosis of HBV-related HCC and that the combination of AFP and PIVKA-II with the γ-GT/ALT ratio could improve the diagnostic value of these biomarkers for HBV-related HCC. Moreover, the ratio of γ-GT/ALT may be a useful index in monitoring patients for progression of HBV-related HCC.

StephenW

γ-谷氨酰轉移酶和丙氨酸轉氨酶比，甲胎蛋白以及維生素K缺乏或拮抗劑II誘導的蛋白在乙型肝炎病毒相關肝細胞癌中的診斷價值
王光榮1 2 3，小蘭路1 2，秦都1 2，張國元1 2，王東昇1 3，王強4 5 6，郭小蘭7 8 9
隸屬關係
隸屬關係

    1個
    四川省南充市，四川北醫學院附屬醫院檢驗醫學科。
    2
    四川省南充市，川北醫學院，轉化醫學中心，檢驗醫學學院。
    3
    四川省北充川北醫學院檢驗醫學系，中國四川省南充市。
    4
    四川省南充市，川北醫學院附屬醫院檢驗醫學科。 [email protected]。
    5
    四川省南充市，川北醫學院，轉化醫學中心，檢驗醫學學院。 [email protected]。
    6
    四川省北充川北醫學院檢驗醫學系，中國四川省南充市。 [email protected]。
    7
    四川省南充市，川北醫學院附屬醫院檢驗醫學科。 [email protected]。
    8
    四川省南充市，川北醫學院，轉化醫學中心，檢驗醫學學院。 [email protected]。
    9
    四川省北方醫學院，四川北醫學院檢驗醫學系。 [email protected]。

    PMID：32782270 DOI：10.1038 / s41598-020-70241-5

抽象

肝細胞癌是常見的惡性腫瘤，預後較差。迫切需要識別和利用標記物進行監測和診斷。甲胎蛋白（AFP）和缺乏維生素K或拮抗劑II（PIVKA-II）誘導的蛋白質已被證明是乙型肝炎病毒（HBV）相關的肝細胞癌（HCC）的有效生物標誌物。兩種標記物的組合可以提高檢測率。然而，這些指標不能滿足臨床診斷的需要。有必要發現新穎的血清學標誌物，以及更具成本效益的，這些標誌物的適當組合，以用於HBV相關性HCC的診斷和監測。因此，在這項研究中，我們旨在評估單獨或與AFP和PIVKA-II組合使用的γ-谷氨酰轉移酶（γ-GT）與丙氨酸轉移酶（ALT）比率對HBV相關性HCC的診斷價值。這項研究納入了234例HBV相關HCC患者和396例慢性乙型肝炎（CHB）患者，並得到了機構審查委員會的批准。我們的結果顯示，早期HCC，HCC，HCC加HBV DNA陽性且HCC加HBV DNA陰性的患者的AFP和PIVKA-II水平以及γ-GT/ ALT比均高於相應的CHB對照組。此外，HBV相關性HCC患者的血清AFP和PIVKA-II水平以及γ-GT/ ALT比值與腫瘤大小呈正相關。早期HCC，HCC，HCC加HBV DNA陽性，HCC加HBV DNA陰性的患者的γ-GT/ ALT比ROC曲線（AUROCs）分別為0.795、0.846、0.855和0.837 ; γ-GT/ ALT比和PIVKA-II的組合的AUROC分別為0.858、0.928、0.948和0.902； γ-GT/ ALT比和AFP的組合的AUROC分別為0.822、0.886、0.896和0.873;γ-GT/ ALT比和PIVKA-II與AFP的組合的AUROC分別為0.857、0.928、0.946和PIVKA-II和AFP組合的AUROC分別為0.907和0.804，0.904、0.942和0.863。總之，γ-GT/ ALT比值是診斷HBV相關肝癌的有用生物標誌物，AFP和PIVKA-II與γ-GT/ ALT比值的組合可以提高這些生物標誌物對HBV的診斷價值。相關的HCC。此外，γ-GT/ ALT的比率可能是監測患者HBV相關HCC進展的有用指標。

StephenW

https://www.nature.com/articles/s41598-020-70241-5.pdf

桦子

本文概括为；
，早期HCC，HCC，HCC加HBV DNA陽性且HCC加HBV DNA陰性的患者的AFP和PIVKA-II水平以及γ-GT/ ALT比均高於相應的CHB對照組。
HBV相關性HCC患者的血清AFP和PIVKA-II水平以及γ-GT/ ALT比值與腫瘤大小呈正相關.
γ-GT/ ALT的比率可能是監測患者HBV相關HCC進展的有用指標.