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Liver Int:高尔基体蛋白73联合肝硬度检测可准确评估慢性乙肝患者的显著性肝纤维化

2017-08-23 MedSci MedSci原创

血清高尔基体蛋白73(GP73)是诊断肝纤维化分期的一项潜在生物学标志物。本研究的目的是建立一种基于GP73水平和肝硬度检测(LS)的算法,以进一步提高诊断显著性肝纤维化分期准确性。

血清高尔基体蛋白73(GP73)是诊断肝纤维化分期的一项潜在生物学标志物。本研究的目的是建立一种基于GP73水平和肝硬度检测(LS)的算法,以进一步提高诊断显著性肝纤维化分期准确性。


本研究纳入慢性乙型肝炎(CHB)初治患者,包括建模组267例患者和验证组133例患者。检测两组患者血清GP73水平,且基于血清GP73水平和肝脏硬度值(LS),建立GP73-LS算法,分别对GP73和GP73-LS诊断显著性肝纤维化的准确性进行评估。

结果表明:CHB初治患者血清GP73水平随肝纤维化分期的增加而逐步升高。血清GP73与纤维化分期显著相关(p < 0.001),是显著性纤维化独立的预测指标 (p < 0.001)。评估显著性肝纤维化方面,肝硬度检测(曲线下面积:0.82,准确性:74.7%)和GP73水平检测(曲线下面积:0.76,准确性:71.5%)优于APRI (曲线下面积:0.69,准确性:66%)和FIB-4 (曲线下面积:0.66,准确性:63.6%)。应用GP73-LS算法,联合GP73<63和LS<8.5排除显著性肝纤维化的准确度为81.7%。联合GP73≥63和LS≥8.5预测显著性肝纤维化的准确度为93.3%。64%的建模组和68%的验证组患者能被准确的判断纤维化分期。

由此可见,血清GP73是判断显著性肝纤维化分期的重要生物标志物。GP73-LS算法优于现有的无创诊断性方法。超过60%的CHB初治患者,可以通过GP73-LS算法判断肝纤维化分期,而不必再进行肝穿。

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