Chu Shanshan, Chen Yingjun, Wang Yemin
Department of Infectious Diseases, People's Hospital of Tiantai County, No. 1, Kangning Middle Road, Taizhou, Zhejiang, 317200, China.
Department of Infectious Diseases, Traditional Chinese Medical Hospital of Tiantai County, No.355, Labor Road, Tiantai County, Taizhou, Zhejiang, 317200, China.
BMC Gastroenterol. 2025 Feb 15;25(1):82. doi: 10.1186/s12876-025-03672-x.
Chronic Hepatitis B (CHB) is a leading cause of liver fibrosis and cirrhosis worldwide. The early detection of liver fibrosis remains challenging due to the lack of specific symptoms and noninvasive biomarkers with high sensitivity. The polymeric immunoglobulin receptor (PIGR) has recently emerged as a potential biomarker for liver fibrosis. This study aims to evaluate the utility of PIGR in CHB patients as a biomarker for liver fibrosis.
This retrospective study analyzed 150 CHB patients from 2018 to 2023. Based on liver biopsy results, 34 patients were classified as having liver fibrosis, while 116 were categorized as non-fibrosis. Clinical data were compared to assess the relationship between PIGR expression levels and serum fibrosis indices. Logistic regression was performed to identify factors influencing liver fibrosis, and the predictive value of PIGR was evaluated using a receiver operating characteristic (ROC) curve.
Significant differences were observed in collagen type IV (CIV), procollagen type III N-terminal peptide (PCIIINP), and hyaluronic acid (HA) levels between the fibrosis and non-fibrosis groups (P < 0.05). PIGR levels were significantly higher in the fibrosis group (P < 0.05) and positively correlated with HA, laminin (LN), PCIII, and CIV levels (P < 0.05). Logistic regression identified HA, LN, PCIIINP, and CIV as risk factors, with PIGR being an independent predictor (P < 0.05). At a cutoff value of 0.35, PIGR showed an area under the curve (AUC) of 0.839, with 81.90% sensitivity, 79.41% specificity, and a Youden's index of 0.613. PIGR also provided a higher net benefit than APRI.
PIGR levels are significantly elevated in CHB-related liver fibrosis and correlate closely with established fibrosis markers. As an independent predictor, PIGR demonstrates high diagnostic accuracy and holds promise as a non-invasive biomarker for detecting liver fibrosis in CHB patients, with significant potential for clinical application.
慢性乙型肝炎（CHB）是全球肝纤维化和肝硬化的主要原因。由于缺乏特异性症状以及高灵敏度的非侵入性生物标志物，肝纤维化的早期检测仍然具有挑战性。聚合免疫球蛋白受体（PIGR）最近已成为肝纤维化的潜在生物标志物。本研究旨在评估PIGR在CHB患者中作为肝纤维化生物标志物的效用。
这项回顾性研究分析了2018年至2023年的150例CHB患者。根据肝活检结果，34例患者被分类为患有肝纤维化，而116例被分类为无纤维化。比较临床数据以评估PIGR表达水平与血清纤维化指标之间的关系。进行逻辑回归以确定影响肝纤维化的因素，并使用受试者工作特征（ROC）曲线评估PIGR的预测价值。
纤维化组和无纤维化组之间的IV型胶原（CIV）、III型前胶原N端肽（PCIIINP）和透明质酸（HA）水平存在显著差异（P < 0.05）。纤维化组中的PIGR水平显著更高（P < 0.05），并且与HA、层粘连蛋白（LN）、PCIII和CIV水平呈正相关（P < 0.05）。逻辑回归确定HA、LN、PCIIINP和CIV为危险因素，PIGR是独立预测因子（P < 0.05）。在截断值为0.35时，PIGR的曲线下面积（AUC）为0.839，灵敏度为81.90%，特异性为79.41%，约登指数为0.613。PIGR还提供了比APRI更高的净效益。
CHB相关肝纤维化中PIGR水平显著升高，并且与既定的纤维化标志物密切相关。作为独立预测因子，PIGR显示出高诊断准确性，有望作为检测CHB患者肝纤维化的非侵入性生物标志物，具有显著的临床应用潜力。
