Department of Laboratory Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China.
Front Cell Infect Microbiol. 2023 Jan 25;13:1082390. doi: 10.3389/fcimb.2023.1082390. eCollection 2023.
Chronic viral hepatitis (CH) is a stage prior to cirrhosis and primary cancer. Standard protocols for CH assessment during the long follow-up period are of great importance for precise treatment and living quality improvement. In this study, we aimed to analyze multiple serum indexes in chronic hepatitis B (CHB)-infected patients and to discuss their combined values in clinical applications.
Total 503 lines of laboratory data from 2012 to 2021 were extracted from103 CHB patients who were followed-up in our hospital. They were divided into the remission group and the progression group according to their complete clinical information and laboratory data. A series of models of serum indexes were analyzed to illustrate the fluctuation trend of @ach index in a time-dependent manner.
The models revealed that abundant serum alpha-fetoprotein (AFP) in the remission group was characteristically associated with hepatocyte destruction markers aspartate aminotransferase (AST) and alanine aminotransferase and favored a much longer progression-free period (P 0.0001). A model-derived equation consisting of serum AFP and AST values showed a good performance (83% reliability) to distinguish the two groups.
This study clearly demonstrates the intrinsic quantitative relationship between serum AFP and liver aminotransferases involving antivirus treatment response. The model-based equation compensates for serum hepatitis B virus DNA detection during outpatient follow-up and it may serve as a useful laboratory tool for CHB progression assessment.
慢性病毒性肝炎（CH）是肝硬化和原发性肝癌的前期阶段。在长期随访过程中，CH 评估的标准方案对于精确治疗和提高生活质量非常重要。在这项研究中，我们旨在分析慢性乙型肝炎（CHB）感染患者的多种血清指标，并讨论它们在临床应用中的联合价值。
从我院随访的 103 例 CHB 患者中提取了 2012 年至 2021 年共 503 行实验室数据。根据其完整的临床资料和实验室数据，将其分为缓解组和进展组。分析了一系列血清指标模型，以说明每个指标在时间依赖性方面的波动趋势。
模型表明，缓解组中丰富的血清甲胎蛋白（AFP）与肝细胞破坏标志物天冬氨酸转氨酶（AST）和丙氨酸转氨酶特征性相关，并有利于更长的无进展期（P<0.0001）。由血清 AFP 和 AST 值组成的模型方程表现出良好的性能（83%的可靠性），可以区分两组。
本研究清楚地表明了血清 AFP 与肝转氨酶之间涉及抗病毒治疗反应的内在定量关系。基于模型的方程弥补了门诊随访期间检测血清乙型肝炎病毒 DNA 的不足，它可能成为 CHB 进展评估的有用实验室工具。
