肝硬化和肝癌患者四种肝纤维化指标和肝功能指标的比较

StephenW

Comparison of four markers of hepatic fibrosis and hepatic function indices in patients with liver cirrhosis and hepatoma
Hong-Yu Ma  1 , Lei Dong  1 , Shou-Zhen Quan  1 , Ruo-Yi Li  1 , Xiang-Rong Wang  2
Affiliations
Affiliations

    1
    Clinical Laboratory Department, Air Force Medical Center, PLA, Beijing, China.
    2
    Medical Assurance Center, Air Force Medical Center, PLA, Beijing, China. [email protected].

    PMID: 33832299 DOI: 10.21037/apm-20-1623

Abstract

Background: The present study aimed to compare four hepatic fibrosis markers [i.e., hyaluronic acid (HA), laminin (LN), procollagen III N-terminal peptide (PIIINP), and collagen type IV (CIV)] and 16 hepatic function indices in patients with liver cirrhosis of varying etiology.

Methods: The hepatic function indices and hepatic fibrosis markers were measured in 108 patients with liver cirrhosis and hepatoma using an automatic biochemical analyzer and luminescent immune analyzer. Twenty healthy controls were enrolled to compare the differences between liver cirrhosis and hepatoma of varying etiology and to analyze the correlations between the hepatic function indices and fibrosis markers.

Results: There was no correlation between alanine aminotransferase (ALT), total protein (TP), alkaline phosphatase (ALP), or the four markers of hepatic fibrosis in liver cirrhosis caused by hepatitis B (P>0.05). Aspartate aminotransferase (AST) was positively correlated with HA (r=0.428, P=0.007), LN (r=0.458, P=0.004), and CIV (r=0.374, P=0.021). Total bilirubin (TBIL) and direct bilirubin (DBIL) were positively correlated with LN (TBIL: r=0.480, P=0.002; DBIL: r=0.457, P=0.004), PIIINP (TBIL: r=0.380, P=0.017; DBIL: r=0.406, P=0.011), and CIV (TBIL: r=0.415, P=0.010; DBIL: r=0.400, P=0.013). Total bile acid (TBA) and γ-glutamyltranspeptidase (GGT) were positively correlated with PIIINP (TBA: r=0.363, P=0.025; GGT: r=0.353, P=0.029) and CIV (TBA: r=0.419, P=0.009; GGT: r=0.335, P=0.040). Leucine aminopeptidase (LAP) was positively correlated with LN (r=0.482, P=0.002). Cholinesterase (CHE) (HA: r=-0.452, P=0.004, LN: r=-0.336, P=0.039; PIIINP: r=-0.468, P=0.003; CIV: r=-0.485, P=0.002), prealbumin (PA) (HA: r=-0.575, P=0.000, LN: r=-0.413, P=0.010; PIIINP: r=-0.344, P=0.035; CIV: r=-0.371, P=0.022), albumin (ALB) (HA: r=-0.541, P=0.000, LN: r=-0.373, P=0.021; PIIINP: r=-0.353, P=0.030; CIV: r=-0.415, P=0.010), and superoxide dismutase (SOD) (HA: r=-0.334, P=0.040, LN: r=-0.347, P=0.033; PIIINP: r=-0.487, P=0.002; CIV: r=-0.536, P=0.001) were negatively correlated with the four markers of hepatic fibrosis. There was no correlation between ALT, AST, TBIL, TP, ALP, GGT, or the four hepatic fibrosis markers in hepatoma caused by hepatitis B (P>0.05). Meanwhile, DBIL and TBA were positively correlated with CIV (DBIL: r=0.519, P=0.023; TBA: r=0.563, P=0.012), while CHE (r=-0.604, P=0.006), ALB (r=-0.564, P=0.012), and SOD (r=-0.489, P=0.034) were negatively correlated with CIV. Moreover, PA was negatively correlated with LN (r=-0.510, P=0.026) and CIV (r=-0.696, P=0.001).

Conclusions: The concentrations of the serological indices differed significantly based on the specific liver cirrhosis etiology. There was a strong correlation between the hepatic function indices and four hepatic fibrosis markers. Thus, the detection of these markers might improve the diagnosis and treatment of hepatoma.

Keywords: Fibrosis-4 index; chepatic cancer; cirrhosis; collagen type IV; hyaluronic acid; laminin; procollagen III N-terminal peptide.

StephenW

肝硬化和肝癌患者四种肝纤维化指标和肝功能指标的比较
马宏宇1，雷东1，权守真1，李若一1，王向荣2
隶属关系
隶属关系

    1个
    中国人民解放军空军医学中心临床检验科，北京。
    2个
    中国人民解放军空军医疗中心医疗保障中心，北京，中国。 [email protected]。

    PMID：33832299 DOI：10.21037 / apm-20-1623

抽象的

背景：本研究旨在比较四种肝纤维化指标[即，透明质酸（HA），层粘连蛋白（LN），前胶原III N末端肽（PIIINP）和IV型胶原（CIV）]和16种肝功能指数肝硬化患者病因各异。

方法：采用自动生化分析仪和发光免疫分析仪对108例肝硬化和肝癌患者的肝功能指标和肝纤维化指标进行测定。纳入20名健康对照者，以比较病因不同的肝硬化与肝癌之间的差异，并分析肝功能指标与纤维化标志物之间的相关性。

结果：丙型肝炎所致肝硬化的丙氨酸氨基转移酶（ALT），总蛋白（TP），碱性磷酸酶（ALP）与肝纤维化的四个标志物之间无相关性（P> 0.05）。天冬氨酸转氨酶（AST）与HA（r = 0.428，P = 0.007），LN（r = 0.458，P = 0.004）和CIV（r = 0.374，P = 0.021）呈正相关。总胆红素（TBIL）和直接胆红素（DBIL）与LN正相关（TBIL：r = 0.480，P = 0.002; DBIL：r = 0.457，P = 0.004），PIIINP（TBIL：r = 0.380，P = 0.017; DBIL：r = 0.406，P = 0.011）和CIV（TBIL：r = 0.415，P = 0.010； DBIL：r = 0.400，P = 0.013）。总胆汁酸（TBA）和γ-谷氨酰转肽酶（GGT）与PIIINP（TBA：r = 0.363，P = 0.025; GGT：r = 0.353，P = 0.029）和CIV（TBA：r = 0.419，P = 0.009; GGT：r = 0.335，P = 0.040）。亮氨酸氨肽酶（LAP）与LN呈正相关（r = 0.482，P = 0.002）。胆碱酯酶（CHE）（HA：r = -0.452，P = 0.004，LN：r = -0.336，P = 0.039; PIIINP：r = -0.468，P = 0.003; CIV：r = -0.485，P = 0.002），前白蛋白（PA）（HA：r = -0.575，P = 0.000，LN：r = -0.413，P = 0.010; PIIINP：r = -0.344，P = 0.035; CIV：r = -0.371，P = 0.022），白蛋白（ALB）（HA：r = -0.541，P = 0.000，LN：r = -0.373，P = 0.021; PIIINP：r = -0.353，P = 0.030; CIV：r = -0.415，P = 0.010），和超氧化物歧化酶（SOD）（HA：r = -0.334，P = 0.040，LN：r = -0.347，P = 0.033; PIIINP：r = -0.487，P = 0.002; CIV：r = -0.536，P = 0.001 ）与肝纤维化的四个标志物呈负相关。乙型肝炎引起的肝癌中ALT，AST，TBIL，TP，ALP，GGT或四种肝纤维化指标之间无相关性（P> 0.05）。同时，DBIL和TBA与CIV呈正相关（DBIL：r = 0.519，P = 0.023; TBA：r = 0.563，P = 0.012），而CHE（r = -0.604，P = 0.006），ALB（r =- 0.564，P = 0.012）和SOD（r = -0.489，P = 0.034）与CIV呈负相关。此外，PA与LN（r = -0.510，P = 0.026）和CIV（r = -0.696，P = 0.001）呈负相关。

结论：血清学指标的浓度因肝硬化的具体病因而异。肝功能指数与四个肝纤维化标志物之间存在很强的相关性。因此，这些标志物的检测可能会改善肝癌的诊断和治疗。

关键字：纤维化4指数；肝癌肝硬化IV型胶原;透明质酸层粘连蛋白前胶原III N末端肽。

StephenW

https://apm.amegroups.com/article/viewFile/65570/pdf