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| HBV慢性感染患者血清ANGPTL 3 4 6水平临床价值研究 |
| The clinical value study of serum ANGPTL 3 4 6 levels in patients with chronic infection with HBV |
| 投稿时间：2022-04-11 |
| DOI：10.3969/j.issn.1000-0399.2023.01.005 |
| 中文关键词: 慢性乙型肝炎 肝癌 血管生成素样蛋白4 肿瘤坏死因子-α |
| 英文关键词: Chronic hepatitis B Hepatocellular carcinoma Angiopoietin-like protein-4 Tumor necrosis factor-α |
| 基金项目:安徽省教育厅重点项目(编号:KJ2018A1024) |
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| 中文摘要: |
| 目的 应用Luminex液相芯片技术检测血管生成素样蛋白(ANGPTL)3、4、6在乙型肝炎病毒(HBV)慢性感染患者血清中表达水平及变化趋势,探究其临床意义。方法 选取2020年9月至2021年1月就诊于蚌埠医学院第一附属医院的64例HBV慢性感染患者为HBV慢性感染组,包含肝癌(HCC组)患者18例和非肝癌(非HCC组)患者46例,其中非HCC组进一步分为慢性乙型肝炎(CHB)组(n=24)和肝硬化(LC)组(n=22),同时随机选取排除肝胆系统疾病的18例健康者作为对照组。收集研究对象的血清样本及相关临床资料数据,检测ANGPTL 3、4、6和肿瘤坏死因子-α(TNF-α)、胆碱酯酶(CHE)血清水平,运用受试者工作特征(ROC)曲线评估其对HBV慢性感染者发生HCC的诊断价值。结果 与对照组相比,HBV慢性感染组血清中CHE、ANGPTL 3、ANGPTL 6水平降低(P＜0.05),ANGPTL 4、TNF-α水平升高(P＜0.05)。CHB组、LC组、HCC组3组间血清ANGPTL 4、TNF-α水平呈升高趋势,HCC组与CHB组、LC组间血清ANGPTL 4、TNF-α水平差异均有统计学意义(P＜0.05);ANGPTL 6水平呈下降趋势,CHB与HCC组间ANGPTL 6水平差异有统计学意义(P＜0.05);CHE在CHB患者中较其他两组都高且分别与LC、HCC组间差异都有统计学意义(P＜0.05)。与非HCC组相比,HCC组患者血清ANGPTL 4、TNF-α水平升高(P＜0.05),ANGPTL 6水平降低(P＜0.05)。ANGPTL 4、TNF-α单独检测评估HBV感染者HCC发生时ROC曲线下面积(AUC)分别为0.762、0.779,ANGPTL 4检测灵敏度为83.33%,优于TNF-α单独检测及ANGPTL 4+TNF-α联合检测时的灵敏度,但特异度仅58.69%。ANGPTL 4+TNF-α联合检测时AUC为0.804,特异度(78.26%)优于单因子检测,灵敏度为72.22%。结论 HBV慢性感染患者血清ANGPTL 3、4水平下降,ANGPTL 6水平上升且ANGPTL 4与TNF-α联合检测评估HBV慢性感染者患HCC的诊断价值优于单独检测。 |
| 英文摘要: |
| Objective to detect the expression levels and trends of angiopoietin-like protein (ANGPTL) 3, 4 and 6 in the serum of HBV chronically infected patients via the application of Luminex liquid-phase microarray technology, and to investigate its clinical significance. Methods A total of 64 patients with chronic HBV infection admitted to the First Affiliated Hospital of Bengbu Medical College from September 2020 to January 2021 were selected as the HBV chronic infection group, including 18 patients with liver cancer (HCC group) and 46 patients with non-liver cancer (non-HCC group), among which the non-HCC group was further divided into chronic hepatitis B (CHB) group (n=24) and liver cirrhosis (LC) group (n=22), while 18 healthy individuals with excluded hepatobiliary system diseases were randomly selected as the control group. Serum samples and related clinical data of the subjects were collected, and the serum levels of ANGPTL 3, 4, 6, tumor necrosis factor-α (TNF-α) and cholinesterase (CHE) were detected, and the diagnostic value of the subjects with chronic HBV infection was evaluated by using the receiver working characteristics (ROC) curve. Results Compared with the control group, the serum levels of CHE, ANGPTL 3 and ANGPTL 6 were reduced (P<0.05), and the levels of ANGPTL 4 and TNF-α were raised (P<0.05) in the HBV chronic infection group. The levels of serum ANGPTL 4 and TNF-α between the CHB, LC and HCC groups showed an increasing trend, and the levels of serum ANGPTL 4 and TNF-α between the HCC group and the CHB group and the LC group had statistically significant difference (P<0.05). The level of ANGPTL 6 showed a downward trend, and the difference between CHB and HCC groups was statistically significant (P<0.05). There were significant differences between HCC groups (P<0.05). Compared with the non-HCC group, serum ANGPTL 4 and TNF-α levels increased (P<0.05) and ANGPTL 6 levels decreased (P<0.05) in the HCC group. The area under the ROC curve (AUC) under the ROC curve (AUC) was 0.762 and 0.779 when liver cancer in HBV-infected patients was evaluated by ANGPTL 4 and TNF-α alone, respectively, and the sensitivity of ANGPTL 4 detection was 83.33%, which was better than the sensitivity of TNF-α alone and ANGPTL 4+TNF-α combined detection, but the specificity was only 58.69%. The AUC of ANGPTL 4+TNF-α was 0.804, and the specificity (78.26%) was better than that of single-factor detection, and the sensitivity was 72.22%. Conclusions Serum ANGPTL 3 and ANGPTL 4 levels decrease and ANGPTL 6 levels increase in HBV chronic infected patients. The diagnostic value of combined detection of ANGPTL 4 and TNF-α in patients with HBV chronic infection is better than that of alone in the evaluation of liver cancer in patients with chronic HBV infection. |
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