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慢性丙型肝炎患者血清甲胎蛋白水平的评估

Evaluation of Serum Alpha-Fetoprotein Level in Chronic Hepatitis C Patients.

作者信息

Yang Na, Li Zhuoran, Yan Min, Xiao Wende, Zhang Weihong, Long Youmin, Cheng Yingzi, Ming Kaihua, Xu Banglao

出版信息

Clin Lab. 2019 Jan 1;65(1). doi: 10.7754/Clin.Lab.2018.180607.

Abstract

BACKGROUND

Hepatitis C virus (HCV) infection represents an important risk factor for hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is a widely used biomarker for HCC. However, elevated serum AFP levels in different statuses of chronic hepatitis C (CHC) is not well defined. This study aimed to evaluate the relationship between AFP levels and HCV viral load in CHC patients. We also analyzed the correlation between three liver func-tion enzyme levels (AST, ALT, GGT) and HCV RNA viral load in CHC patients.

METHODS

A total of 279 patients infected with HCV were included in this study. Patients were divided into two groups: HCV RNA positive and HCV RNA negative group. Serum HCV RNA load was measured by Quantitative Real-time PCR. Electrochemiluminescence assay (ECLA) was used to determine the serum AFP levels. The differences between two groups in AFP levels and biochemical profile (AST, ALT, GGT) was evaluated.

RESULTS

The HCV RNA-positive group had significantly higher serum AFP levels than the negative groups (12.61 vs. 4.72 ng/mL, p < 0.0001). There was no correlation between AFP levels and HCV RNA viral load in HCV infection patients (p = 0.92). A significant correlation was observed between serum ALT (r = 0.243, p = 0.005), GGT (r = 0.212, p = 0.016) levels and HCV RNA viral load. Poor correlation (r = 0.148, p = 0.093) was found between AST levels and HCV RNA viral load. Interestingly, there was a positive correlation (r = 0.337, p < 0.001) between ALT and AFP levels in the whole study population.

CONCLUSIONS

We concluded that serum HCV RNA positive patients were candidates for therapeutic prevention of HCC and liver inflammation regardless of the HCV RNA viral load. Furthermore, higher burden of HCV viral load was associated with more severe liver damage.

摘要

背景

丙型肝炎病毒(HCV)感染是肝细胞癌(HCC)的一个重要危险因素。甲胎蛋白(AFP)是一种广泛用于HCC的生物标志物。然而,慢性丙型肝炎(CHC)不同状态下血清AFP水平升高的情况尚不明确。本研究旨在评估CHC患者中AFP水平与HCV病毒载量之间的关系。我们还分析了CHC患者三种肝功能酶水平(AST、ALT、GGT)与HCV RNA病毒载量之间的相关性。

方法

本研究共纳入279例HCV感染患者。患者分为两组:HCV RNA阳性组和HCV RNA阴性组。采用定量实时聚合酶链反应检测血清HCV RNA载量。用电化学发光法(ECLA)测定血清AFP水平。评估两组在AFP水平和生化指标(AST、ALT、GGT)上的差异。

结果

HCV RNA阳性组血清AFP水平显著高于阴性组(12.61对4.72 ng/mL,p<0.0001)。HCV感染患者的AFP水平与HCV RNA病毒载量之间无相关性(p = 0.92)。血清ALT(r = 0.243,p = 0.005)、GGT(r = 0.212,p = 0.016)水平与HCV RNA病毒载量之间存在显著相关性。AST水平与HCV RNA病毒载量之间的相关性较差(r = 0.148,p = 0.093)。有趣的是,在整个研究人群中,ALT与AFP水平呈正相关(r = 0.337,p<0.001)。

结论

我们得出结论,无论HCV RNA病毒载量如何,血清HCV RNA阳性患者都是HCC和肝脏炎症治疗性预防的候选者。此外,更高的HCV病毒载量负担与更严重的肝损伤相关。

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