Department of Infectious Diseases, Jiaotong University School of Medicine, Ruijin Hospital, Shanghai, China.
Liver Int. 2010 Feb;30(2):259-67. doi: 10.1111/j.1478-3231.2009.02170.x. Epub 2009 Nov 27.
We previously reported on serum N-glycans as markers for the diagnosis of cirrhosis in patients with chronic hepatitis C infection. Our present study aimed to evaluate the use of serum glycan markers for the diagnosis of liver fibrosis in patients with chronic hepatitis B infection.
Patients with hepatitis B virus (HBV) infection (n=173) were diagnosed by clinical laboratory analysis and histological examination. Liver fibrosis was staged using Ishak score. N-glycan profiles of serum proteins were determined by DNA sequencer-based carbohydrate analytical profiling.
We found that in HBV patients, like in hepatitis C virus patients, several serum N-glycans were altered during the development of liver fibrosis. We found higher levels of total agalactosylated biantennary glycans in fibrosis patients with HBV infection than in healthy controls. The biantennary (NA2) and the triantennary (NA3) N-glycans decreased significantly (P<0.001) with increased severity of fibrosis. The diagnostic power of serum glycan marker (GlycoFibroTest) [area under the curve (AUC)=0.735) was similar to that of FibroTest (AUC=0.740) for discriminating between moderate and advanced fibrosis (F3-F6) from non- or mild fibrosis (F0-F2). However, GlycoFibroTest (AUC=0.740) was slightly better than FibroTest (AUC=0.696) for distinguishing fibrotic patients (F1 or more) from non-fibrotic patients (F0).
The assay for serum glycan profiling showed satisfactory reproducibility and is a non-invasive blood test for the diagnosis of liver fibrosis. The changes of N-glycan level in serum can be used to monitor or follow-up the progress of fibrosis using specific N-glycan markers.
我们之前报道过血清 N-糖链作为慢性丙型肝炎感染患者肝硬化诊断标志物。本研究旨在评估血清糖链标志物在乙型肝炎病毒(HBV)感染患者肝纤维化诊断中的应用。
通过临床实验室分析和组织学检查诊断乙型肝炎病毒感染患者(n=173)。采用 Ishak 评分对肝纤维化进行分期。采用 DNA 测序仪基于碳水化合物分析的方法检测血清蛋白的 N-糖链谱。
我们发现,与丙型肝炎病毒患者一样,HBV 患者在肝纤维化发展过程中几种血清 N-糖链发生改变。我们发现,HBV 感染纤维化患者的总半乳糖基双天线糖的水平高于健康对照组。双天线(NA2)和三天线(NA3)N-糖链随着纤维化严重程度的增加而显著降低(P<0.001)。血清糖链标志物(GlycoFibroTest)的诊断能力[曲线下面积(AUC)=0.735]与 FibroTest(AUC=0.740)相似,可区分中度至晚期纤维化(F3-F6)与非或轻度纤维化(F0-F2)。然而,GlycoFibroTest(AUC=0.740)在区分纤维化患者(F1 或更严重)与非纤维化患者(F0)方面略优于 FibroTest(AUC=0.696)。
血清糖谱分析检测具有良好的重现性,是一种用于诊断肝纤维化的非侵入性血液检测。血清 N-糖链水平的变化可用于使用特定的 N-糖链标志物监测或随访纤维化的进展。