乙型肝炎e抗原阳性和阴性慢性乙型肝炎患者血清肝实质细胞

StephenW

乙型肝炎e抗原阳性和阴性慢性乙型肝炎患者血清肝实质细胞体积标准化乙型肝炎表面抗原水平的临床价值
谭雷 1 , 徐世雷 2 , 墨志硕 3 4 , 刘建荣 5 , 甘伟强 3 4 , 陈洁欢 6 , 高志良 3 4 , 吴泽谦 3 4
隶属关系
隶属关系

    1
    广州中山大学附属第三医院超声医学科。
    2
    广州中山大学附属第三医院普外科。
    3
    广州中山大学附属第三医院感染科。
    4
    中山大学教育部局部疾病防治重点实验室，广州，中国。
    5
    广州中山大学附属第三医院外科及移植重症监护室。
    6
    【作者单位】： 东莞市滨海湾中心医院超声科;

    PMID：34733983 PMCID：PMC8506748 DOI：10.21037/atm-21-3846

抽象的

背景：虽然血清乙型肝炎表面抗原 (HBsAg) 在乙型肝炎病毒 (HBV) 感染的诊断和治疗结果评估中起重要作用，但目前尚不清楚标准化为肝实质细胞体积 (HPCV) 的 HBsAg 水平是否更好。疾病状态的指标。本研究比较了乙型肝炎 e 抗原 (HBeAg) 阳性和 HBeAg 阴性慢性乙型肝炎 (CHB) 患者的绝对和 HPCV 标准化血清 HBsAg 水平。

方法：回顾性纳入我们机构的 CHB 患者，并将其分为 HBeAg 阳性和 HBeAg 阴性组。 HPCV是根据肝活检标本的病理检查和球体几何理论计算的。 HBsAg 水平和 HBsAg 之间的差异对 HPCV 进行了标准化，并且还分析了 HBsAg 水平与肝脏炎症和纤维化之间的相关性。

结果：与 HBeAg 阴性患者相比，HBeAg 阳性患者的绝对 HBsAg 水平 (P=0.004)，而非 HPCV 标准化的 HBsAg 水平 (P=0.071) 显着更高。在 HBeAg 阳性 CHB 患者中，绝对 HBsAg 水平与肝脏炎症分级（R=0.285，P=0.001）和肝纤维化阶段（R=0.351，P<0.001）呈正相关，HPCV 标准化的 HBsAg 水平（R= 0.640 和 0.742，两者，P<0.001)。然而，在 HBeAg 阴性 CHB 患者中，只有 HPCV 标准化的 HBsAg 水平与肝脏炎症分级和肝纤维化分期相关（R=0.640 和 0.785，P<0.001）。

结论：HPCV 标准化的血清 HBsAg 水平，而不是绝对 HBsAg 水平，与 HBeAg 阳性和 HBeAg 阴性 CHB 患者的肝脏炎症分级和肝纤维化阶段呈正相关。因此，与绝对 HBsAg 水平相比，HPCV 标准化的 HBsAg 水平可能更准确地反映 CHB 患者的病理进展。

关键词：血清乙肝表面抗原水平（血清HBsAg水平）；肝纤维化阶段;肝实质细胞体积（肝细胞数量）；肝脏炎症分级。

2021 年转化医学年鉴。版权所有。

StephenW

The clinical value of serum hepatic parenchyma cell volume-normalized hepatitis B surface antigen levels in hepatitis B e antigen -positive and -negative chronic hepatitis B patients
Lei Tan  1 , Shi-Lei Xu  2 , Zhi-Shuo Mo  3   4 , Jian-Rong Liu  5 , Wei-Qiang Gan  3   4 , Jie-Huan Chen  6 , Zhi-Liang Gao  3   4 , Ze-Qian Wu  3   4
Affiliations
Affiliations

    1
    Department of Medical Ultrasonic, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
    2
    Department of General Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
    3
    Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
    4
    Key Laboratory of Topical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China.
    5
    Surgical and Transplant Intensive Care Unit, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
    6
    Department of Ultrasound, Binhaiwan Central Hospital of Dongguan, Dongguan, China.

    PMID: 34733983 PMCID: PMC8506748 DOI: 10.21037/atm-21-3846

Abstract

Background: While serum hepatitis B surface antigens (HBsAg) play an important role in the diagnosis and assessment of treatment results of hepatitis B virus (HBV) infections, it remains unclear whether HBsAg levels normalized to hepatic parenchymal cell volume (HPCV) is a superior indicator of disease state. This study compared the absolute and HPCV-normalized serum HBsAg levels in hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients with chronic hepatitis B (CHB).

Methods: Patients admitted to our institution with CHB were retrospectively included and categorized into the HBeAg-positive and HBeAg-negative groups. HPCV was calculated based on pathological examination of liver biopsy specimens and theory of sphere geometry. The difference between HBsAg levels and HBsAg normalized to HPCV, and also correlation between HBsAg levels and liver inflammation and fibrosis was analyzed.

Results: Absolute HBsAg levels (P=0.004), but not HPCV-normalized HBsAg levels (P=0.071) were significantly higher in HBeAg-positive patients compared to HBeAg-negative patients. In HBeAg-positive CHB patients, absolute HBsAg levels were positively correlated with liver inflammation grade (R=0.285, P=0.001) and hepatic fibrosis stage (R=0.351, P<0.001), as were HPCV-normalized HBsAg levels (R=0.640 and 0.742, both, P<0.001). However, in HBeAg-negative CHB patients, only HPCV-normalized HBsAg level were correlated with liver inflammation grade and hepatic fibrosis stage (R=0.640 and 0.785, both, P<0.001).

Conclusions: HPCV-normalized serum HBsAg levels, rather than absolute HBsAg levels, were positively correlated with liver inflammation grade and hepatic fibrosis stage in both HBeAg-positive and HBeAg-negative CHB patients. Thus, HPCV-normalized HBsAg levels may more accurately reflect the pathological progress of CHB patients compared to absolute HBsAg levels.

Keywords: Serum hepatitis B surface antigens level (serum HBsAg level); hepatic fibrosis stages; hepatic parenchyma cell volume (hepatic cell quantities); liver inflammation grades.

2021 Annals of Translational Medicine. All rights reserved.

StephenW

https://atm.amegroups.com/article/viewFile/78657/pdf

小牡丹

不靠谱。没有数据支持，有点外行。

StephenW

也是不切实际的 , 这也是不切实际的，因为计算 HPCV 需要活检.但研究强调血清HBsAg取决于是否存在纤维化和纤维化程度 , 就像肝硬化中ALT通常较低或正常一样 .

"as fibrosis increases, the effective hepatic cell quantity (HPCV) decreases. Undoubtedly, when there are fewer hepatic parenchyma cells for host HBV replication, HBsAg production will be reduced, lowering serum HBsAg levels (20,21)."
随着纤维化程度的增加，有效肝细胞数量 (HPCV) 减少。 毫无疑问，当宿主HBV复制的肝实质细胞较少时，HBsAg的产生就会减少，
降低血清 HBsAg 水平 (20,21)。