慢性乙型肝炎血清HMGB1水平在肝纤维化无创诊断中的价值

THE NONINVASIVE DIAGNOSTIC VALUE OF SERUM HMGB1 LEVELS IN ASSESSING HEPATIC FIBROSIS OF CHRONIC HEPATITIS B PATIENTS

目的探讨慢性乙型肝炎患者血清中高迁移率族蛋白B1(High-mobility Group Box 1,HMGB1)水平与肝脏纤维化程度的关系,并评估血清HMGB1水平在乙肝肝纤维化无创性诊断中的价值。方法将68例经病理活检证实为肝纤维化的患者按照病理组织学评分分成三组,即无纤维化组(S0)、低纤维化组(S1～S2)及高纤维化组(S3～S4)。检测所有患者血清HMGB、ALT水平及HBVDNA滴度,并分析血清HMGB1水平与血清ALT、HBV-DNA及肝脏纤维化间的关系。结果低纤维化组及高纤维化组患者血清HMGB1水平明显高于无纤维化组,而低纤维化组血清HMGB1水平明显高于高纤维化组,且血清HMGB1水平是肝纤维化的独立预测因子;ROC曲线示血清HMGB1诊断肝纤维化程度的cut off值为68 pg/ml,特异性为79%,敏感性为55%。结论血清HMGB1水平可作为乙肝脏纤维化无创性诊断的敏感指标。

Objective To investigate the relationship between serum HMGB1 levels and liver fibrosis stages in CHB patients, and to assess the clinical value of serum HMGB1 levels in the noninvasive diagnosis of liver fibrosis. Methods According to the path- ological grading, 68 patients were divided into three groups as without fibrosis group（SO） , low fibrosis group（ S1-S2）and high fibro- sis group （S3 -S4 ）. To test all patients with serum HMGB levels, ALT level and HBVDNA titer, and to analyze the relationship be- tween HMGB1 levels and ALT levels, HBV DNA titer, liver fibrosis stages. Results The HMGB1 levels in serum of Low fibrosis group and high level of fibrosis group are obviously higher than that of without fibrosis group, Particularly, Low fibrosis group serum HMGB1 level was significantly higher than that of high fibrosis group ,and The level of HMGB1 is an independent predictor of hepatic fibrosis; ROC curve showed that serum HMGB1 in the diagnosis of hepatic fibrosis of stages cut off 68 pg/ml, 79% specifieity, sensi- tivity of 55%. Conclusion Serum HMGB1 levels has the potential to be a uniquely sensitive and specific marker for liver fibrosis.