Zhang Hao, Ding Jiayun, Zhou Yingzhen
Laboratory Department, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine Suzhou 215000, Jiangsu, China.
Laboratory Department, Suzhou Guangci Cancer Hospital Suzhou 215000, Jiangsu, China.
Am J Transl Res. 2024 Jun 15;16(6):2301-2309. doi: 10.62347/BDLO2786. eCollection 2024.
To investigate the clinical implication of quantitative polymerase chain reaction (PCR)-based high-sensitivity detection of hepatitis B virus (HBV)-DNA levels in patients with HBV-related liver cirrhosis (LC).
From January 2020 to December 2022, 100 fasting serum samples were collected and retrospectively analyzed from patients with treated HBV-related LC attending the Suzhou Hospital of Integrated Traditional Chinese and Western Medicine and Suzhou Guangci Cancer Hospital. Patients were divided into a negative group (HBV-DNA < 20 IU/mL) and a positive group (HBV-DNA ≥ 20 IU/mL) according to their high-sensitivity HBV-DNA test results. The clinical characteristics and serological indicators of the two groups were compared, mainly including gender, age, liver function [total protein (TP), albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL)], lipids [total cholesterol (TC) and triglycerides (TG)], platelets (PLT), five serum liver fibrosis markers [cholyglycine (CG), hyaluronic acid (HA), laminin (LN), precollagen type III (PCIII), and type IV collagen (IV-C)], serum gastrointestinal tumor markers [α-fetoprotein (AFP) and carcinoembryonic antigen (CEA)], and hepatitis B surface antigen (HBsAg). The differences between the two groups in terms of liver function Child-Pugh grades and the incidence of hepatocellular carcinoma (HCC) were also compared.
There were 39 patients in the positive group, including 29 males and 10 females, and 61 patients in the negative group, including 38 males and 23 females, with no statistically significant differences in gender and age distribution between the two groups (P > 0.05). The levels of serological indicators (TP, ALB, AST, GGT, ALP, TBIL, DBIL, IBIL, TC, TG, PLT, CG, HA, LN, PCIII, IV-C, AFP, CEA, and HBsAg) in both groups showed no significant differences (P > 0.05), but the ALT level in the positive group was higher than that in the negative group (P < 0.0001). The positive group had worse Child-Pugh grades and higher HCC incidence compared to the negative group (P < 0.0001, P = 0.028).
Patients with HBV-related LC and HBV-DNA ≥ 20 IU/mL have higher serum ALT levels, worse liver function Child-Pugh grades, and higher HCC incidence than those with HBV-DNA < 20 IU/mL. High-sensitivity HBV-DNA quantification can reflect the deterioration of liver function in patients with HBV-related LC to some extent.
探讨基于定量聚合酶链反应（PCR）的高灵敏度检测乙型肝炎病毒（HBV）-DNA水平在HBV相关肝硬化（LC）患者中的临床意义。
收集2020年1月至2022年12月期间在苏州市中西医结合医院和苏州广慈肿瘤医院接受治疗的HBV相关LC患者的100份空腹血清样本，并进行回顾性分析。根据高灵敏度HBV-DNA检测结果，将患者分为阴性组（HBV-DNA<20 IU/mL）和阳性组（HBV-DNA≥20 IU/mL）。比较两组患者的临床特征和血清学指标，主要包括性别、年龄、肝功能[总蛋白（TP）、白蛋白（ALB）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、γ-谷氨酰转肽酶（GGT）、碱性磷酸酶（ALP）、总胆红素（TBIL）、直接胆红素（DBIL）和间接胆红素（IBIL）]、血脂[总胆固醇（TC）和甘油三酯（TG）]、血小板（PLT）、五项血清肝纤维化标志物[胆甘酸（CG）、透明质酸（HA）、层粘连蛋白（LN）、Ⅲ型前胶原（PCIII）和Ⅳ型胶原（IV-C）]、血清胃肠道肿瘤标志物[甲胎蛋白（AFP）和癌胚抗原（CEA）]以及乙肝表面抗原（HBsAg）。还比较了两组患者在肝功能Child-Pugh分级和肝细胞癌（HCC）发生率方面的差异。
阳性组有39例患者，其中男性29例，女性10例；阴性组有61例患者，其中男性38例，女性23例。两组患者的性别和年龄分布差异无统计学意义（P>0.05）。两组患者的血清学指标（TP、ALB、AST、GGT、ALP、TBIL、DBIL、IBIL、TC、TG、PLT、CG、HA、LN、PCIII、IV-C、AFP、CEA和HBsAg）水平差异均无统计学意义（P>0.05），但阳性组的ALT水平高于阴性组（P<0.0001）。与阴性组相比，阳性组的Child-Pugh分级更差，HCC发生率更高（P<0.0001，P=0.028）。
与HBV-DNA<20 IU/mL的患者相比，HBV相关LC且HBV-DNA≥20 IU/mL的患者血清ALT水平更高，肝功能Child-Pugh分级更差，HCC发生率更高。高灵敏度HBV-DNA定量检测在一定程度上可以反映HBV相关LC患者肝功能的恶化情况。
