Clinical Liver Center, The 910th Hospital of the People's Liberation Army, Quanzhou, 362000, China.
Clinical Liver Center, Decheng hospital of Quanzhou/Affiliated of Huaqiao University, Quanzhou, 362000, China.
Sci Rep. 2019 Feb 4;9(1):1170. doi: 10.1038/s41598-018-36480-3.
This study aimed to assess the feasibility of GP73 as a diagnostic marker for liver inflammation and fibrosis in chronic HBV patients with normal or slightly raised ALT (<2 ULN) and to develop models based on GP73 and other biochemical parameters to improve diagnostic accuracy. Serum GP73 levels were analyzed in 220 chronic HBV patients with normal or slightly raised ALT who underwent liver biopsy. The results showed that the area under the receiver operating characteristic (ROC) curve (AUC) was 0.806 for predicting significant liver inflammation (≥G2), while it was 0.742 for predicting significant fibrosis (≥S2). These results suggest that GP73 has higher diagnostic value for liver inflammation than liver fibrosis. Combining GP73, AST and ALB, as a diagnostic model for predicting significant liver inflammation, resulted in superior diagnostic performance over GP73 alone (AUC value increased from 0.806 to 0.854, z = 2.299, P = 0.021). By applying this diagnostic model, over 80% of chronic HBV patients with normal or slightly raised ALT will be correctly identified and hence avoid delay in diagnosis and treatment. In conclusion, GP73 would be an additional serum marker for predicting liver inflammation and fibrosis in chronic HBV patients with normal or slightly raised ALT.
本研究旨在评估 GP73 作为 ALT（<2ULN）正常或轻度升高的慢性乙型肝炎患者肝炎症和纤维化的诊断标志物的可行性，并建立基于 GP73 和其他生化参数的模型以提高诊断准确性。对 220 例 ALT 正常或轻度升高行肝活检的慢性乙型肝炎患者进行血清 GP73 水平分析。结果显示，预测显著肝炎症（≥G2）的受试者工作特征曲线（ROC）下面积（AUC）为 0.806，而预测显著纤维化（≥S2）的 AUC 为 0.742。这些结果表明，GP73 对肝炎症的诊断价值高于肝纤维化。将 GP73 联合 AST 和 ALB 作为预测显著肝炎症的诊断模型，其诊断性能优于单独使用 GP73（AUC 值从 0.806 增加到 0.854，z=2.299，P=0.021）。应用该诊断模型，80%以上 ALT 正常或轻度升高的慢性乙型肝炎患者将被正确识别，从而避免延误诊断和治疗。总之，GP73 可作为预测 ALT 正常或轻度升高的慢性乙型肝炎患者肝炎症和纤维化的附加血清标志物。
