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血清 N-糖基化标志物联合 panel 可提高慢性乙型肝炎的诊断。

Serum N-glycomic markers in combination with panels improves the diagnosis of chronic hepatitis B.

机构信息

Department of Gastroenterology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.

出版信息

Ann Hepatol. 2012 Mar-Apr;11(2):202-12.

Abstract

AIM

The present study aimed to evaluate the changes in the serum N-glycome profiles in chronic hepatitis B (CHB) patients and to assess the role of N-glycome-derived markers in the noninvasive diagnosis of liver fibrosis.

MATERIALS AND METHODS

After liver biopsy for pathological grading and staging, 128 CHB patients underwent serum N-glycomic analysis using DNA sequencer-assisted fluorophore-assisted carbohydrate electrophoresis (DSA-FACE) and sensitive markers were screened.

RESULTS

Peaks 1, 2, 8 and 10 in the N-glycome profiles could, to some extents, distinguish liver fibrosis at different stages. In addition, the N-glycome-derived marker log(peak2/peak8) possessed the highest diagnostic accuracy. The areas under the receiver operating characteristic (AUROCs) curves of the log(peak2/peak8) were 0.675, 0.736 and 0.754 in the diagnosis of significant fibrosis, advanced fibrosis and early cirrhosis, respectively. In combination with some marker panels (SLFG, S index, Fibrometer, Hui, Forns, APRI and Hepascore), it showed the best diagnostic potency in distinguishing significant fibrosis (SLFG + log[peak2/peak8], AUROC = 0.813) from advanced fibrosis (SLFG + log[peak2/peak8], AUROC = 0.899) and a better diagnostic potency in the identification of early cirrhosis (S index + log[peak2/peak8], AUROC = 0.903, lower than Hui model [AUROC = 0.927]) in the validation cohort.

CONCLUSIONS

N-glycomic changes are present in the serum of CHB patients with liver fibrosis, and N-glycan profiling is a noninvasive and effective tool to assess the liver fibrosis, especially in combination with serum marker panels.

摘要

目的

本研究旨在评估慢性乙型肝炎(CHB)患者血清 N-糖组谱的变化,并评估 N-糖衍生标志物在肝纤维化无创诊断中的作用。

材料与方法

对 128 例 CHB 患者进行肝活检进行病理分级和分期后,采用 DNA 测序仪辅助荧光辅助糖电泳(DSA-FACE)进行血清 N-糖组学分析,筛选敏感标志物。

结果

N-糖组谱中的峰 1、2、8 和 10 可以在一定程度上区分不同阶段的肝纤维化。此外,N-糖衍生标志物 log(peak2/peak8)具有最高的诊断准确性。log(peak2/peak8)在诊断显著纤维化、进展性纤维化和早期肝硬化的受试者工作特征(ROC)曲线下面积(AUROCs)分别为 0.675、0.736 和 0.754。与某些标志物组合(SLFG、S 指数、Fibrometer、Hui、Forns、APRI 和 Hepascore)结合使用,其在区分显著纤维化(SLFG+log[peak2/peak8],AUROC=0.813)和进展性纤维化(SLFG+log[peak2/peak8],AUROC=0.899)方面显示出最佳诊断效力,并且在验证队列中对早期肝硬化(S 指数+log[peak2/peak8],AUROC=0.903,低于 Hui 模型 [AUROC=0.927])的鉴别诊断具有更好的诊断效力。

结论

肝纤维化 CHB 患者血清中存在 N-糖组学变化,N-糖组学分析是一种评估肝纤维化的非侵入性和有效工具,特别是与血清标志物组合使用时。

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