Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, PR China.
Liver Research Center, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis & National Clinical Research Center of Digestive Diseases, Beijing 100050, PR China.
Clin Chim Acta. 2019 Jun;493:92-97. doi: 10.1016/j.cca.2019.02.019. Epub 2019 Feb 20.
Non-invasive method to identify chronic hepatitis B (CHB) patients with at least moderate inflammatory lesion but no increased ALT is an unmet need. We evaluated Golgi protein 73 (GP73) based hepatic inflammation model (HIM) as a serum surrogate for liver necroinflammatory activity, especially in those with ALT less than traditional upper concentration.
The diagnostic performances of HIM were evaluated in 2 independent cohorts of liver biopsy proved CHB patients by receiver operating characteristic (ROC) curve analysis.
HIM, a suggested index combined GP73, gamma-glutamyltransferase and AST, could significantly improve the diagnostic accuracy for liver necroinflammation (Area under ROC, AUROC: 0.890). More importantly, HIM still exhibit excellent diagnostic value (AUROC: 0.873) to identify patients with at least moderate liver necroinflammatory activity but with ALT <40 U/l. Serum GP73 was the major source of improvement for diagnostic model's accuracy.
HIM is probably a promising non-invasive index to identify CHB patients with moderate to severe liver necroinflammation, especially in those with ALT <40 U/l.
寻找一种非侵入性的方法，以识别出至少有中度炎症病变但 ALT 未升高的慢性乙型肝炎（CHB）患者，这是一个尚未满足的需求。我们评估了基于高尔基糖蛋白 73（GP73）的肝炎症模型（HIM）作为血清肝坏死性炎症活性的替代物，特别是在那些 ALT 低于传统上限的患者中。
通过接受者操作特征（ROC）曲线分析，在两个独立的肝活检证实的 CHB 患者队列中评估 HIM 的诊断性能。
HIM 是一个由 GP73、γ-谷氨酰转移酶和 AST 组成的建议指标，可以显著提高肝坏死性炎症的诊断准确性（ROC 曲线下面积，AUROC：0.890）。更重要的是，HIM 仍然具有出色的诊断价值（AUROC：0.873），可识别出至少有中度肝坏死性炎症活动但 ALT<40 U/l 的患者。血清 GP73 是提高诊断模型准确性的主要来源。
HIM 可能是一种有前途的非侵入性指标，可用于识别出中度至重度肝坏死性炎症的 CHB 患者，特别是在那些 ALT<40 U/l 的患者中。
