Kang Q, Liu J X, Tan N, Chen H Y, Pan J L, Han Y F, Xu X Y
Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China.
Department of Gastroenterology, Peking University First Hospital, Beijing 100034, China.
Zhonghua Gan Zang Bing Za Zhi. 2023 Jan 20;31(1):56-64. doi: 10.3760/cma.j.cn501113-20220329-00149.
To investigate the efficacy of chitinase-3-like protein 1 (CHI3L1) and Golgi protein 73 (GP73) in the diagnosis of cirrhosis and the dynamic changes of CHI3L1 and GP73 after HCV clearance in patients with chronic hepatitis C (CHC) treated with direct-acting antiviral drugs (DAAs). The comparison of continuous variables of normal distribution were statistically analyzed by ANOVA and -test. The comparison of continuous variables of non-normal distribution were statistically analyzed by rank sum test. The categorical variables were statistically analyzed by Fisher's exact test and (2) test. Correlation analysis was performed using Spearman correlation analysis. Data of 105 patients with CHC diagnosed from January 2017 to December 2019 were collected. The receiver operating characteristic curve (ROC curve) was plotted to study the efficacy of serum CHI3L1 and GP73 for the diagnosis of cirrhosis. Friedman test was used to compare CHI3L1 and GP73 change characteristics. The areas under the ROC curve for CHI3L1 and GP73 in the diagnosis of cirrhosis at baseline were 0.939 and 0.839, respectively. Serum levels of CHI3L1 and GP73 in the DAAs group decreased significantly at the end of treatment compared with baseline [123.79 (60.25, 178.80) ng/ml vs. 118.20 (47.68, 151.36) ng/ml, = 0.001; 105.73 (85.05, 130.69) ng/ml vs. 95.52 (69.52, 118.97) ng/ml, = 0.001]. Serum CHI3L1 and GP73 in the pegylated interferon combined with ribavirin (PR) group were significantly lower at the end of 24 weeks of treatment than the baseline [89.15 (39.15, 149.74) ng/ml vs. 69.98 (20.52, 71.96) ng/ml, < 0.05; 85.07 (60.07, 121) ng/ml vs. 54.17 (29.17, 78.65) ng/ml, < 0.05]. CHI3L1 and GP73 are sensitive serological markers that can be used to monitor the fibrosis prognosis in CHC patients during treatment and after obtaining a sustained virological response. Serum CHI3L1 and GP73 levels in the DAAs group decreased earlier than those in the PR group, and the serum CHI3L1 levels in the untreated group increased compared with the baseline at about two years of follow-up.
探讨几丁质酶3样蛋白1（CHI3L1）和高尔基体蛋白73（GP73）在肝硬化诊断中的效能，以及接受直接抗病毒药物（DAAs）治疗的慢性丙型肝炎（CHC）患者HCV清除后CHI3L1和GP73的动态变化。采用方差分析和t检验对正态分布的连续变量进行统计学比较。采用秩和检验对非正态分布的连续变量进行统计学比较。采用Fisher确切检验和卡方检验对分类变量进行统计学分析。使用Spearman相关分析进行相关性分析。收集了2017年1月至2019年12月诊断的105例CHC患者的数据。绘制受试者工作特征曲线（ROC曲线）以研究血清CHI3L1和GP73对肝硬化的诊断效能。采用Friedman检验比较CHI3L1和GP73的变化特征。基线时CHI3L1和GP73诊断肝硬化的ROC曲线下面积分别为0.939和0.839。与基线相比，DAAs组治疗结束时血清CHI3L1和GP73水平显著降低[123.79（60.25，178.80）ng/ml对118.20（47.68，151.36）ng/ml，P = 0.001；105.73（85.05，130.69）ng/ml对95.52（69.52，118.97）ng/ml，P = 0.001]。聚乙二醇干扰素联合利巴韦林（PR）组治疗24周结束时血清CHI3L1和GP73显著低于基线[89.15（39.15，149.74）ng/ml对69.9（20.52，71.96）ng/ml，P < 0.05；85.07（60.07，121）ng/ml对54.17（29.17，78.65）ng/ml，P < 0.05]。CHI3L1和GP73是敏感的血清学标志物，可用于监测CHC患者治疗期间及获得持续病毒学应答后的纤维化预后。DAAs组血清CHI3L1和GP73水平比PR组下降更早，未治疗组血清CHI3L1水平在随访约两年时较基线升高。
