甲胎蛋白在慢性乙型肝炎感染分期中的预后意义
Prognostic Significance of Alpha-Fetoprotein in Staging of Chronic Hepatitis B Infection.
作者信息
Ayelagbe Olubunmi Gloria, Suleiman Ibrahim Eleha, Adekunle Olutoyin Catherine, Adedeji Adebayo Lawrence
机构信息
Chemical Pathology Department, Ladoke Akintola University of Technology, Ogbomoso, Nigeria.
Microbiology and Parasitology Department, University of Rwanda, Butare, Rwanda.
出版信息
Rwanda J Med Health Sci. 2023 Nov 30;6(3):355-366. doi: 10.4314/rjmhs.v6i3.9. eCollection 2023 Nov.
BACKGROUND
Ascertaining the stage of chronic hepatitis-B infection (CHBI) remains one of the major predicaments to effective therapeutic decision. There is pressing need to forestall dearth of such reliable biomarker(s). Despite the promising tendency of alpha-fetoprotein (AFP), it has not been assessed in staging CHBI.
OBJECTIVE
This study was to determine the prognosis of serum AFP as a biomarker for staging CHBI.
METHODS
Participants were grouped into three based on their hepatitis-B envelope antigen (HBeAg) status and alanine aminotransferase (ALT) level. By denoting HbeAg(+) as (EP), HbeAg(-) as (EN), elevated ALT as (H) and normal ALT as (I), the stages were EPH, ENH and ENI. AFP was assayed, One-way ANOVA, Multivariate linear regression and area under curve were adopted for the analysis.
RESULTS
AFP was significantly elevated, (P < 0.05) in EPH, which equally has the highest prevalence of elevated AFP (64.7%). After adjusting for confounding factors, odds ratio was 1.438 (95% CI, 0.62-1.948), while area under the curve for predicting EPH was (0.828, 95% CI, 0.778 -0.895).
CONCLUSIONS
The finding of elevated AFP in CHBI is an independent prognostic marker of EPH. It is often associated with necroinflammation; thus, it is a reliable indicator for treatment initiation.
背景
确定慢性乙型肝炎感染（CHBI）的阶段仍然是有效治疗决策的主要困境之一。迫切需要避免此类可靠生物标志物的缺乏。尽管甲胎蛋白（AFP）有良好的发展趋势，但尚未在CHBI分期中进行评估。
目的
本研究旨在确定血清AFP作为CHBI分期生物标志物的预后情况。
方法
根据参与者的乙肝e抗原（HBeAg）状态和丙氨酸转氨酶（ALT）水平将其分为三组。将HbeAg(+)表示为（EP），HbeAg(-)表示为（EN），ALT升高表示为（H），ALT正常表示为（I），阶段分为EPH、ENH和ENI。检测AFP，采用单因素方差分析、多元线性回归和曲线下面积进行分析。
结果
AFP在EPH组显著升高（P<0.05），该组AFP升高的患病率也最高（64.7%）。在调整混杂因素后，优势比为1.438（95%CI，0.62 - 1.948），而预测EPH的曲线下面积为（0.828，95%CI，0.778 - 0.895）。
结论
CHBI中AFP升高的发现是EPH的独立预后标志物。它常与坏死性炎症相关；因此，它是开始治疗的可靠指标。
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