细胞角蛋白18-M30/M65用于中老年脂肪肝筛查的临床价值

Clinical value of serum cytokeratin 18-M30 and M65 in screening of fatty liver among middle-aged and older people

目的:探讨血清细胞角蛋白18(cytokeratin 18,CK18)-M30和M65片段(CK18-M30/M65)水平用于筛查脂肪肝的临床价值.方法:选取中老年健康体检者血清样本130例,剔除谷丙转氨酶(alanine transaminase,ALT)或谷草转氨酶(aspartate transaminase,AST)超标样本,根据肝区B超结果分成"健康肝"和"脂肪肝"两组,用M30和M65定量检测试剂盒检测,比较两组M30和M65的表达水平.结果:脂肪肝组CK18-M30和M65的中位数分别为141 U/L(80-498 U/L)和133 U/L(0-564 U/L),健康肝组CK18-M30和M65的中位数分别为111 U/L(27-319 U/L)和77 U/L(0-305 U/L),两组之间F检验的P值分别为0.0027和0.00007,差异非常显著.当CK18-M30以200 U/L作为cut-off值时,脂肪肝组CK18-M30的阳性率为28.57%(16/56),健康肝组的阳性率为5.41%(4/74),两组间差异有统计学意义(P<0.001);当CK18-M65以250 U/L作为cut-off值时,脂肪肝组的阳性率为21.43%(12/56),健康肝组的阳性率为5.41%(4/74);CK18-M30和M65联合时,脂肪肝组的阳性率为46.43%(26/56),健康肝组的阳性率为10.81%(8/74).结论:血清CK18-M30和M65水平可能是中老年健康体检脂肪肝的有效筛查指标.

AIM： To assess the clinical value of serum cytokeratin 18-M30 and M65 fragment（CK18-M30/M65） in screening fatty liver among middle-aged and older people.METHODS： One hundred and thirty serum samples were collected from people aged 51-95 years who underwent a physical examination. Samples with abnormal alanine transaminase（ALT） or aspartate transaminase（AST） were excluded. Individuals were divided into healthy liver and fatty liver groups according to ultrasound results. CK18-M30 and M65 expression levels were detected using CK18-M30 and M65 quantitative detection kits.RESULTS： The medians of M30 and M65 in thefatty liver group were 141 U/L（80-498 U/L） and 133 U/L（0-564 U/L）, respectively, which were significantly higher than those in the healthy liver group [111 U/L（27-319 U/L） and 77 U/L（0-305 U/L）, P = 0.0027, 0.00007]. When the cut-off value of M30 was set at 200 U/L, the positive rates in the fatty liver group and healthy liver group were 28.57%（16/56） and 5.41%（4/74）, respectively（P 0.001）. When 250 U/L was chosen as the cut-off of M65, the positive rates in the fatty liver group and healthy liver group were 21.43%（12/56） and 5.41%（4/74）, respectively. If either M30 200 U/L or M65 250 U/L was used as a positive standard, the positive rate in the fatty group was 46.43%（26/56）, but only 10.81%（8/74） in the healthy group.CONCLUSION： Serum CK18-M30 and M65 might be helpful in screening fatty liver in middle-aged and older populations.