Department of Clinical Laboratory, Zigong Third People's Hospital, Sichuan, P.R.[aff_start] [/aff_end]China.
Department of pharmaceutical preparation, Zigong Third People's Hospital, Sichuan, P.R.[aff_start] [/aff_end]China.
Medicine (Baltimore). 2023 Oct 27;102(43):e35699. doi: 10.1097/MD.0000000000035699.
Hepatitis B virus (HBV) is closely related to the occurrence and development of primary liver cancer (PLC). The early diagnosis of PLC is difficult. The study explored the clinical application value of the HBV gene basal core promoter (BCP) region 1762/1764 combined with gamma-glutamyl transpeptidase (GGT) and its isozyme II (GGTII) in PLC.
From June 2017 to June 2021, 145 hepatitis B surface antigen-positive and HBV DNA-positive patients were enrolled in the Third People Hospital of Zigong. Of them, 67 were chronic hepatitis B (CHB) patients, 30 were liver cirrhosis patients, and 48 were patients with hepatitis B-associated PLC. The HBV BCP 1762/1764 mutation was detected through the amplification refractory mutation system fluorescence PCR method, and GGTII was detected using the double-antibody sandwich method.
The results showed that the serum GGT activity, GGTII level, aspartate aminotransferase (AST) activity, AST/alanine aminotransferase (ALT) ratio, GGT/ALT ratio, and GGT/AST ratio were significantly different between the PLC and CHB groups. Statistically significant differences in serum GGT activity, AST activity, and GGT/ALT ratio were observed between the PLC and LC groups. The BCP 1762/1764 mutation rate between the PLC and CHB groups was statistically significant. The GGTII level in the early PLC (stage I + II) group and the advanced PLC (stage III + IV) group was higher than that in the N-PLC group. Serum GGT activity in the early PLC and advanced PLC groups was higher than that in the N-PLC group. The area under the curve of the receiver operator characteristic curve of GGT and GGTII for diagnosing PLC was 0.775 (95% confidence interval [CI] [0.697, 0.854]) and 0.608 (95% CI [0.512, 0.704]), respectively. The area under curve of GGT and GGTII for diagnosing early PLC was 0.732 (95% CI [0.620, 0.845]) and 0.579 (95% CI [0.452, 0.706]), respectively.
HBV gene BCP 1762/1764 mutation, GGT, and GGTII may be related to PLC occurrence. The HBV gene BCP region 1762/1764 combined with GGT has certain clinical diagnostic values for PLC and early PLC. However, GGTII is not a good indicator of early PLC and is more relevant to advanced PLC.
乙型肝炎病毒（HBV）与原发性肝癌（PLC）的发生和发展密切相关。PLC 的早期诊断较为困难。本研究探讨 HBV 基因基本核心启动子（BCP）区 1762/1764 联合γ-谷氨酰转肽酶（GGT）及其同工酶 II（GGTII）在 PLC 中的临床应用价值。
选取 2017 年 6 月至 2021 年 6 月自贡市第三人民医院收治的 145 例乙型肝炎表面抗原阳性且 HBV DNA 阳性患者，其中慢性乙型肝炎（CHB）患者 67 例，肝硬化患者 30 例，乙型肝炎相关 PLC 患者 48 例。采用扩增受阻突变系统荧光 PCR 法检测 HBV BCP 1762/1764 突变，双抗体夹心法检测 GGTII。
结果显示，PLC 组和 CHB 组患者血清 GGT 活性、GGTII 水平、天门冬氨酸氨基转移酶（AST）活性、AST/丙氨酸氨基转移酶（ALT）比值、GGT/ALT 比值和 GGT/AST 比值比较差异均有统计学意义（P<0.05）；PLC 组和 LC 组患者血清 GGT 活性、AST 活性和 GGT/ALT 比值比较差异均有统计学意义（P<0.05）。PLC 组和 CHB 组患者 HBV BCP 1762/1764 突变率比较差异有统计学意义（P<0.05）。早期 PLC（Ⅰ+Ⅱ期）组和晚期 PLC（Ⅲ+Ⅳ期）组 GGTII 水平均高于 N-PLC 组，血清 GGT 活性均高于 N-PLC 组（P<0.05）。GGT 和 GGTII 对 PLC 诊断的受试者工作特征曲线（ROC）曲线下面积分别为 0.775（95%置信区间 [CI] [0.697, 0.854]）和 0.608（95% CI [0.512, 0.704]）。GGT 和 GGTII 对早期 PLC 诊断的 ROC 曲线下面积分别为 0.732（95% CI [0.620, 0.845]）和 0.579（95% CI [0.452, 0.706]）。
HBV 基因 BCP 区 1762/1764 突变、GGT 和 GGTII 可能与 PLC 的发生有关。HBV 基因 BCP 区 1762/1764 联合 GGT 对 PLC 及早期 PLC 具有一定的临床诊断价值，而 GGTII 对早期 PLC 并非良好指标，与晚期 PLC 相关性更高。
