血浆高尔基体糖蛋白73和血小板计数在不同阶段HBV相关肝病中的表达及意义

Diagnostic values of plasma Golgi protein-73 and platelet count for different stages of HBV-related liver diseases

目的分析不同阶段HBV相关肝病患者外周血高尔基体糖蛋白73(GP73)水平和血小板(PLT)计数,了解二者对不同发病阶段HBV相关肝病的检测意义。方法收集2010年5月-2013年8月于北京佑安医院就诊的36例慢性乙型肝炎(CHB)、32例肝硬化和147例肝硬化后肝细胞癌(HCC)患者外周血标本,利用ELISA检测GP73水平,用全自动血细胞分析仪检测PLT。计量资料多组间比较用单因素方差分析,计数资料组间比较采用χ2检验,相关性分析用一元线性回归。结果在CHB、肝硬化、肝硬化基础上的HCC早早期、早期、进展期和晚期患者外周血浆中GP73水平和PLT均呈现出相同的变化趋势,HCC早早期患者的GP73水平[(80.5±49.8)ng/ml]和PLT计数[(84.4±40.0)×109/L]均显著低于CHB[(135.5±95.8)ng/ml,(174.4±49.9)×109/L]、HCC进展期[(133.8±71.1)ng/ml,(122.0±70.50)×109/L]和HCC晚期[(192.2±98.1)ng/ml,(176.2±86.3)×109/L],且差异均有统计学意义(P值均<0.01)。结论 GP73水平和PLT计数在HBV相关肝病的不同阶段呈现动态变化,联合动态检测GP73水平和PLT计数更有利于对早期HCC的鉴别诊断以及HCC预后的判断。

Objective To determine the Golgi protein - 73 （ GP73 ） level and platelet （PLT） count in the peripheral blood of patients with hepatitis B virus （HBV） - related liver diseases and to investigate their values in diagnosing different stages of HBV - related liver diseases. Methods Peripheral blood samples were collected from 215 patients treated in Beijing Youan Hospital, including 36 patients with chronic hepatitis B （CHB） , 32 patients with liver cirrhosis （LC） , and 147 patients with hepatocellular carcinoma （HCC）. The level of GP73 was measured by ELISA and the PLT count was determined using the Automatic Hematology Analyzer. Comparison of continuous variables was performed using one - way ANOVA, and comparison of categorical variables using chi - square test. The correlation between different varia- bles was assessed by liner regression analysis. Results GP73 level （ng/ml） and PLT count （ × 10^9/L） displayed similar changes between patients with CHB, LC, pro - early HCC, early HCC, progressive HCC, and advanced HCC. The GP73 level and PLT count were signifi- cantly lower in patients with pro - early HCC （ 80.5 ±49.8 ; 84.4 ±40.0） than in those with CI-tB （ 135.5 ±95.8 ; 174.4 ±49.9 ）, progressive HCC（133.8±71.1; 122.0±70.50）, and advancedHCC（192.2±98.1; 176.2±86.3） （allP〈0.01）. Conclusion GP73 level and PLT count change in patients with different stages of HBV - related diseases. The dynamic monitoring of GP73 level and PLT count is useful in the early diagnosis of HCC and the prognostic judgment of HCC patients.