FibroScan联合GPC3、AFP检测对肝纤维化的诊断价值

Diagnosis Value of FibroScan Combined GPC 3 and AFP Test for the Liver Fibrosis

目的研究FibroScan联合磷脂酰肌醇蛋白聚糖3(GPC3)、甲胎蛋白(AFP)对肝纤维化的诊断价值。方法选择医院2018年1月至2022年12月收治的96例慢性乙型肝炎患者作为研究对象。其中处于S0期的无纤维化患者31例,记为A组,处于S1~S2期的轻度肝纤维化患者35例,记为B组,处于S3~S4期的中重度肝纤维化患者30例,记为C组。对比各组肝功能相关指标,FibroScan、GPC3及AFP水平,分析FibroScan、GPC3及AFP与肝功能相关指标的相关性,分析3项指标对肝纤维化的诊断价值。结果B、C组的谷草转氨酶(GOT)、谷丙转氨酶(GPT)、透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原氨基末端前肽(PⅢNP)、Ⅳ型胶原(Ⅳ-C)、FibroScan、GPC3及AFP水平较A组高,且C组较B组高(P<0.05)。Pearson分析显示,FibroScan、GPC3及AFP与肝功能相关指标均呈正相关(P<0.05)。FibroScan、GPC3及AFP三者联合检测对肝纤维化的诊断价值最高,其曲线下面积为0.905,大于各指标单独检测(0.751、0.633、0.842)。结论肝纤维化程度高的患者FibroScan、GPC3及AFP水平也升高,且三者联合检测对于肝纤维化的诊断价值较高,值得作为监测靶点在临床推广应用。

Objective To study the diagnosis value of FibroScan combined glypican-3(GPC3)and alpha fetoprotein(AFP)in the diagnosis of liver fibrosis.Methods A total of 96 patients with chronic hepatitis B who were admitted to the hospital from January 2018 to December 2022 were selected as the research subjects.Among them,31 patients without fibrosis in S0 stage were classified as group A,35 patients with mild liver fibrosis in stages S1 to S2 were classified as group B,30 patients with moderate and severe liver fibrosis in stages S3 to S4 were classified as group C.The liver function related indicators,FibroScan,GPC3 and AFP indicators levels were compared among groups,the correlation of FibroScan,GPC3 and AFP indicators and liver function related indicators was analyzed,and the diagnostic value of the three indicators on liver fibrosis was analyzed.Results The glutamic-oxaloacetic transaminase(GOT),glutamic-pyruvic transaminase(GPT),hyaluronic acid(HA),laminin(LN),procollagenⅢN-terminal peptide(PⅢNP),tpyeⅣcollagen(Ⅳ-C),FibroScan,GPC3 and AFP levels in group B and group C were higher compared with group A,and those in group C were higher compared with group B(P<0.05).Pearson analysis found that FibroScan,GPC3 and AFP were positively correlated with liver function related indicators respectively(P<0.05).The combination of FibroScan,GPC3 and AFP had the highest diagnostic value for liver fibrosis,the area under the curve was 0.905,which was greater than each indicator detected separately(0.751,0.633,0.842,respectively).Conclusion FibroScan,GPC3 and AFP levels in patients with high degree of liver fibrosis also increase,and the combine detection of the three has diagnostic value for liver fibrosis,which is worth promoting and applying as a monitoring target in clinical practice.