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[GP73在慢性肝病患者肝纤维化诊断价值的研究]

[A study on the diagnostic value of GP73 in liver fibrosis among patients with chronic liver disease].

作者信息

An X Y, Qiao J, Hu L X, Wang R Q, Nan Y M

机构信息

Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University, Shijiazhuang 050051, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2023 Jan 1;62(1):49-53. doi: 10.3760/cma.j.cn112138-20220514-00371.

Abstract

This study aimed to evaluate the diagnostic value of serum Golgi protein 73(GP73) alone and GP73 combined with liver stiffness measurement (LSM), aspartate aminotransferase/platelet ratio index (APRI), and 4-factor-based fibrosis index (FIB4) in diagnosing liver fibrosis in patients with chronic liver disease of different etiologies. A diagnostic test. A total of 68 patients who underwent liver biopsy in the Department of Traditional and Western Medical Hepatology of the Third Hospital of Hebei Medical University from October 2019 to December 2020 were selected to detect serum GP73 levels. iLivTouch was used to assess liver stiffness measurement (LSM). In addition, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), total bilirubin (TBil), direct bilirubin (DBil), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL) levels, and peripheral platelet (PLT) counts were assayed. The correlation between GP73 and the above indexes was assessed, and APRI and FIB-4 were calculated. SPSS 21.0 statistical software was used for statistical analysis. The area under the receiver operating characteristic curve was calculated to evaluate diagnostic efficacy of GP73 in identifying hepatic fibrosis stages. Furthermore, the difference between GP73 and liver stiffness, as well as APRI and FIB4 in diagnosing significant fibrosis was assessed. Based on liver biopsy, 13, 18, 17, and 20 cases were diagnosed as stages S0-1, S2, S3, and S4, respectively. The AUC of GP73 diagnosing hepatic fibrosis stage S≥3 and S=4 were 0.806 and 0.844 at cut-off points of 2.06 and 3.27 μg/L, and the sensitivity and specificity were 93.5%, 61.5%, 90.0%, 70.3%, respectively. In addition, GP73 levels were positively correlated with the degree of liver fibrosis (=0.547, <0.001). The efficacy of serum GP73 level in diagnosing the degree of liver fibrosis in patients with chronic liver disease from different causes was significantly higher than that of APRI, FIB4, and LSM. The combination of GP73 and FIB4 can further improve the accuracy of diagnosis of liver fibrosis staging S≥3 and S=4, which is a reliable serological marker for the diagnosis of fibrosis in patients with chronic liver disease.

摘要

本研究旨在评估血清高尔基体蛋白73(GP73)单独及联合肝脏硬度测量(LSM)、天冬氨酸氨基转移酶/血小板比值指数(APRI)和基于4因子的纤维化指数(FIB4)在不同病因慢性肝病患者肝纤维化诊断中的价值。一项诊断试验。选取2019年10月至2020年12月在河北医科大学第三医院中西医结合肝病科接受肝活检的68例患者检测血清GP73水平。采用iLivTouch评估肝脏硬度测量(LSM)。此外,检测血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)、总胆红素(TBil)、直接胆红素(DBil)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)水平及外周血小板(PLT)计数。评估GP73与上述指标的相关性,并计算APRI和FIB-4。采用SPSS 21.0统计软件进行统计分析。计算受试者工作特征曲线下面积以评估GP73在识别肝纤维化分期中的诊断效能。此外,评估GP73与肝脏硬度以及APRI和FIB4在诊断显著纤维化方面的差异。基于肝活检,分别有13、18、17和20例患者被诊断为S0-1期、S2期、S3期和S4期。GP73诊断肝纤维化分期S≥3期和S=4期的AUC在截断值为2.06和3.27μg/L时分别为0.806和0.844,敏感性和特异性分别为93.5%、61.5%、90.0%、70.3%。此外,GP73水平与肝纤维化程度呈正相关(=0.547,<0.001)。血清GP73水平诊断不同病因慢性肝病患者肝纤维化程度的效能显著高于APRI、FIB4和LSM。GP73与FIB4联合可进一步提高肝纤维化分期S≥3期和S=4期诊断的准确性,是慢性肝病患者纤维化诊断的可靠血清学标志物。

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