Clinical expression significance of PD-1 and Caspase-9 on the surface of PBMC in patients with hepatitis B virus infection at different stages of the disease
Objective To investigate the levels of programmed death receptor-1(PD-1)and cysteinyl aspartate specific proteinase-9(Caspase-9)on the surface of peripheral blood mononuclear cells(PBMC)in different stages of patients with hepatitis B,and to find their clinical expression significance.Methods A total of 224 patients with hepatitis B who were treated in the Department of Infectious Diseases and Hepatology of Xiangtan Central Hospital from March 2020 to September 2022 were selected.All patients were divided into the mild hepatitis B group(n=83),moderate hepatitis B group(n=76),and severe hepatitis B group(n=65)according to their disease stages.21 patients with liver cancer during the same period were selected as the liver cancer group,and 70 health examination personnel during the same period were included in the health group.The liver function indicators,the levels of PD-1 and Caspase-9 on the surface of PBMC in each group of patients with hepatitis B were compared,and the relationship between different stages of the disease and the levels of PD-1 and Caspase-9 on the surface of PBMC was statistically analyzed,as well as its predictive value for the disease stage.Results The levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),and hepatitis B virus-DNA(HBV-DNA)in patients of the mild hepatitis B group,moderate hepatitis B group and severe hepatitis B group,and liver cancer patients were significantly higher than those in the healthy group.AST and ALT in the mild hepatitis B group,moderate hepatitis B group,severe hepatitis B group,and liver cancer group increased in turn,with statistically significant differences between the groups(P<0.05).The levels of PD-1 and Caspase-9 on the PBMC surface in the mild hepatitis B group,moderate hepatitis B group,severe hepatitis B group,and liver cancer group were significantly higher than those in the healthy group(P<0.05).The levels of Caspase-9 in the mild hepatitis B group,moderate hepatitis B group,severe hepatitis B group,and liver cancer group decreased in turn,with statistically significant differences between the groups(P<0.05).The PD-1 on the surface of PBMC in the mild hepatitis B group,severe hepatitis B group,and liver cancer group increased in turn,with statistically significant differences between the groups(P<0.05).There was no difference in PD-1 between the moderate group and the mild group(P>0.05).PD-1 on the surface of PBMC was positively correlated with AST and ALT,and negatively correlated with HBV-DNA,while Caspase-9 was negatively correlated with AST and ALT,and positively correlated with HBV-DNA.The AUC value of the combined detection of PD-1 and Caspase-9 for the development of severe hepatitis B into liver cancer was 0.911,the sensitivity was 90.31%,and the specificity was 89.63%.Conclusion The levels of PD-1 and Caspase-9 on PBMC surface in different stages of hepatitis B patients are significantly different,and the expression levels of PD-1 and Caspase-9 are correlated with liver function indicators.The combined detection of PD-1 and Caspase-9 can predict the development of severe hepatitis B into liver cancer.
Hepatitis BPBMCPD-1Caspase-9Different stages of the disease
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