Combination of serum Golgi protein 73 and liver stiffness for assessing liver fibrosis progression in patients with chronic hepatitis B virus infection
Objective To observe the changes of serum Golgi protein 73(GP73)level and liver stiffness in patients with chronic hepatitis B virus(HBV)infection at different stages of liver fibrosis,and to explore their values in assessing the progression of liver fibrosis.Methods Totally 475 patients with chronic HBV infection were diagnosed and treated in Henan Provincial People's Hospital from January 2018 to October 2019.All patients underwent percutaneous liver biopsy and histopathological examination to assess liver fibrosis stages(S0-S4),and were divided into mild group(S0-S1,n=189)and moderate to severe group(S2-S4,n=286).The serum GP73 level was detected by ELISA,and liver stiffness was assessed using the FibroTouch non-invasive liver assessment system.The platelet count,liver stiffness,and levels of serum GP73,HBV-DNA and hepatitis B surface antigen(HBsAg)were compared between two groups.Multivariate logistic regression analysis was performed to identify the factors influencing moderate to severe liver fibrosis in patients with chronic HBV infection.ROC curves were plotted to evaluate the diagnostic efficiencies of serum GP73 and liver stiffness on moderate to severe liver fibrosis.Results The patients were older in moderate to severe group[(36.47±9.30)years]than in mild group[(33.86±11.86)years](t=2.677,P=0.008).The direct bilirubin,HBV-DNA,HBsAg,GP73,and liver stiffness were higher in moderate to severe group[(4.50±3.25)μmol/L,(4.66±1.32)lgu/mL,(4.15±1.83)lgu/mL,(86.25±31.37)μg/L,(10.34±4.93)kPa]than those in mild group[(3.85±2.65)μmol/L,(4.22±2.53)lgu/mL,(3.24±0.98)lgu/mL,(57.36±12.87)μg/L,(6.42±5.09)kPa](t=2.327,2.476,6.267,12.007,5.758;all P values＜0.05),and the platelet count was lower in moderate to severe group[(170.50±91.02)× 109/L]than that in mild group[(196.00±57.89)× 109/L](t=-3.030,P=0.003).The platelet count(OR=0.964,95％CI:0.941-0.988,P=0.025),serum GP73(OR=1.230,95％CI:1.074-1.424,P=0.003),and liver stiffness(OR=1.349,95％CI:1.134-1.586,P=0.003)were the influencing factors of moderate to severe liver fibrosis in patients with chronic HBV infection.When the optimal cut-off values of serum GP73 and liver stiffness were 86.25 μg/L and 7.95 kPa,the AUCs for diagnosing moderate to severe liver fibrosis were 0.683(95％CI:0.668-0.698,P=0.005)and 0.721(95％CI:0.710-0.732,P=0.001),the sensitivities were 46.6％and 67.3％,and the specificities were 81.2％and 72.0％,respectively.The AUC of the combination of serum GP73 and liver stiffness for diagnosing moderate to severe liver fibrosis was 0.762(95％CI:0.751-0.773,P=0.001),with a sensitivity of 59.8％and a specificity of 79.7％.Conclusion The increase of serum GP73 level and liver stiffness is correlated with the degree of liver fibrosis in patients with chronic HBV infection,and the combination of serum GP73 and liver stiffness can assess the progression of liver fibrosis.
chronic hepatitis B virus infectionliver fibrosisGolgi protein 73liver stiffnesstransient elastography
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