HBsAg携带者血清TSGF与其他肝病标志物检测的意义

Significance of Tumor Supplied Group of Factors and Other Biomarkers for Hepatic Diseases in HBsAg Carriers

目的探讨HBsAg携带者血清TSGF、AFP及其他肝病标志物间的相互关系及其意义. 方法将启东市1989年建立的30～59岁男性HBsAg阳性的高危人群中HBsAg滴度在1∶64及以上,或曾出现AFP阳性的170例患者,于2003年8月采血检测血清TSGF、AFP、ALT、HBVM、HCV及HDV等并随访,用Stata 7.0软件作Logistic回归分析. 结果 TSGF平均值为(70.66±11.62)U/ml,阳性率为51.76%.ALT平均值为(6.41±15.39)U/L,阳性率为16.47%. AFP、HBsAg、抗-HBc、抗-HCV、HDVAg的阳性率分别为12.12%、92.94%、98.24%、4.71%及14.12%.以TSGF作为因变量,用Logistic回归行单因素及多因素分析,未见其他标志物与TSGF有联系.但以AFP作为因变量,则ALT与抗-HCV进入模型,说明两者对AFP有影响(χ2=16.41,P=0.0003).结论 TSGF是一种与现有的肝病指标没有因果联系的、相对独立的生物标志物.TSGF及其他肝病标志物的检测结果表明本组对象为肝病和肝癌的高危人群,对其进行密切随访具有临床和流行病学意义.

Objective To study the interaction and value of tumor supplied group of factors(TSGF),alpha-fetoprotein (AFP),and other biomarkers for hepatic diseases among HBsAg carriers.Methods One hundred and seventy HBsAg carriers from a cohort of males aged 30～59 with positive HBsAg in 1989,whose serum titre of HBsAg were ≥1∶64,or AFP ≥20 μg/L,were tested for serum biomarkers such as TSGF,AFP,ALT,HBVM,HCV,and HDV in 2003.Logistic regression analysis was done by using Stata 7.0 software.Results The positive rate of TSGF was 51.76%,with an average value of 70.66±11.62 U/ml.For ALT,it was 16.47%,with the value of (6.41±15.39)U/L.The positive rates were 12.12% for AFP,92.94% for HBsAg,98.24% for anti-HBc,4.71% for anti-HCV,and 14.12% for HDVAg,respectively.TSGF was used to be dependently variable,no relation was seen between TSGF and other biomarkers (independent variables) by single-variable or multifactor analysis of the logistic regression.ALT and anti-HCV were entered the multi-variable model,with a χ 2 of 16.41,P=0.0003,if AFP was supposed to be a dependent variable.Conclusion TSGF is a relatively independent biomarker,without cause-and-effect relationship to the present biomarkers of hepatic diseases.These subjects may be a high risk population for hepatic diseases and liver cancer.A close follow-up,therefore,has not only clinical value,but also epidemiological value.