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. 2023 Jan 1;62(1):49-53.
doi: 10.3760/cma.j.cn112138-20220514-00371.

[A study on the diagnostic value of GP73 in liver fibrosis among patients with chronic liver disease]

[Article in Chinese]
Affiliations

[A study on the diagnostic value of GP73 in liver fibrosis among patients with chronic liver disease]

[Article in Chinese]
X Y An et al. Zhonghua Nei Ke Za Zhi. .

Abstract

Objective: This study aimed to evaluate the diagnostic value of serum Golgi protein 73(GP73) alone and GP73 combined with liver stiffness measurement (LSM), aspartate aminotransferase/platelet ratio index (APRI), and 4-factor-based fibrosis index (FIB4) in diagnosing liver fibrosis in patients with chronic liver disease of different etiologies. Methods: A diagnostic test. A total of 68 patients who underwent liver biopsy in the Department of Traditional and Western Medical Hepatology of the Third Hospital of Hebei Medical University from October 2019 to December 2020 were selected to detect serum GP73 levels. iLivTouch was used to assess liver stiffness measurement (LSM). In addition, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), total bilirubin (TBil), direct bilirubin (DBil), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL) levels, and peripheral platelet (PLT) counts were assayed. The correlation between GP73 and the above indexes was assessed, and APRI and FIB-4 were calculated. SPSS 21.0 statistical software was used for statistical analysis. The area under the receiver operating characteristic curve was calculated to evaluate diagnostic efficacy of GP73 in identifying hepatic fibrosis stages. Furthermore, the difference between GP73 and liver stiffness, as well as APRI and FIB4 in diagnosing significant fibrosis was assessed. Results: Based on liver biopsy, 13, 18, 17, and 20 cases were diagnosed as stages S0-1, S2, S3, and S4, respectively. The AUC of GP73 diagnosing hepatic fibrosis stage S≥3 and S=4 were 0.806 and 0.844 at cut-off points of 2.06 and 3.27 μg/L, and the sensitivity and specificity were 93.5%, 61.5%, 90.0%, 70.3%, respectively. In addition, GP73 levels were positively correlated with the degree of liver fibrosis (r=0.547, P<0.001). Conclusions: The efficacy of serum GP73 level in diagnosing the degree of liver fibrosis in patients with chronic liver disease from different causes was significantly higher than that of APRI, FIB4, and LSM. The combination of GP73 and FIB4 can further improve the accuracy of diagnosis of liver fibrosis staging S≥3 and S=4, which is a reliable serological marker for the diagnosis of fibrosis in patients with chronic liver disease.

目的: 评估血清高尔基体蛋白73(GP73)单独应用及GP73分别联合肝脏硬度(LSM)、天冬氨酸转氨酶/血小板比值指数(APRI)、基于4因子的纤维化指数(FIB4)诊断不同病因所致慢性肝病患者肝纤维化程度的诊断价值。 方法: 诊断性试验。选择2019年10月至2020年12月就诊于河北医科大学第三医院中西医结合肝病科行肝穿刺活组织病理学检查的患者68例,检测患者血清GP73水平,应用iLivTouch检测肝脏硬度(LSM);收集患者血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转移酶(GGT)、总胆红素(TBil)、直接胆红素(DBil)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)水平和外周血小板(PLT)计数,分析GP73与上述指标的相关性,并计算APRI、FIB4。应用SPSS 21.0统计学软件进行统计学分析,采用受试者工作特征(ROC)曲线计算曲线下面积(AUC),评估GP73诊断肝纤维化分期的诊断效能,并进一步分析其与肝硬度、APRI、FIB4诊断显著纤维化的效能差异。 结果: 经肝穿刺活组织学检查,诊断为肝纤维化分期S0~1期13例,S2期18例,S3期17例,S4期20例;GP73诊断肝纤维化分期S≥3、S=4的AUC分别为0.806和0.844,截断点分别为2.06和3.27 μg/L,敏感度和特异度分别为93.5%、61.5%及90.0%、70.3%。血清GP73水平与肝纤维化程度呈正相关(r=0.547,P<0.001)。 结论: 血清GP73水平在诊断不同病因所致慢性肝病患者肝纤维化程度的诊断效能明显高于APRI、FIB4、LSM。GP73与FIB4联合应用,可进一步提高对肝纤维化分期S≥3和S=4诊断的准确性,是一种诊断慢性肝病患者纤维化的可靠血清学标志物。.

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