血清CHI3L1水平与肝脏疾病之间的关系

The Relationship Between Levels of Serum CHI3L1 and Liver Disease

目的 通过壳多糖酶3样蛋白1(chitinase 3-like protein 1,CHI3L1)在慢性乙型肝炎(chronic hepatitis B,CHB)、自身免疫性肝病(autoimmune liver disease, AILD)、肝硬化(liver cirrhosis, LC)、肝癌(hepatocellular carcinoma, HC)中的水平,为临床监测肝脏疾病进展提供依据。方法 选取菏泽市立医院2022年6月至2023年12月健康体检者60例、慢性乙型肝炎患者60例、自身免疫性肝病患者60例、肝硬化患者60例、肝癌患者60例作为研究对象,应用酶联免疫吸附(ELISA)法检测所有研究对象血清中CHI3L1表达水平;应用流式细胞检测细胞因子表达水平;生化分析仪检测生化指标水平。结果 CHI3L1水平,健康体检组(47.00±20.50ng/mL)<CHB组(91.75±35.58ng/mL)<AILD组(128.30±41.92ng/mL)<LC组(131.29±46.52ng/mL)<HC组(154.07±59.92ng/mL)。以健康体检组为对照,CHI3L1诊断LC的ROC曲线显示,AUC为0.965;CHI3L1诊断HC的ROC曲线显示AUC为0.974。以慢性乙型肝炎组为对照,CHI3L1诊断肝硬化的值AUC为0.749(P<0.001),CHI3L1+AST诊断肝硬化AUC值为0.845(P<0.001),优于CHI3L1检测;以慢性乙型肝炎组为对照,AFP诊断HC的AUC为0.783,CHI3L1诊断HC的AUC为0.800(P<0.001);CHI3L1+AFP诊断HC的AUC为0.891,CHI3L1+AST+IL-17+IL-6诊断肝癌的AUC为0.937(P<0.001),优于CHI3L1和AFP检测。结论 血清CHI3L1表达水平在肝癌组中最高,慢性乙型肝炎组最低,血清CHI3L1表达水平随疾病进展升高;血清CHI3L1可作为辅助诊断肝硬化和肝癌的无创指标;血清CHI3L1、AST、IL-6、IL-17、IL-8、IFN-γ联合检测能够提高对肝硬化和肝癌的诊断。

Objective To investigate the role of Chitinase 3-like protein 1(CHI3L1)in Chronic Hepatitis B(CHB)and Autoimmune Liver disease,(AILD),Liver Cirrhosis(LC),and Hepatocellular Carcinoma(HC),and to provide a knowledge basis for clinical monitoring of liver disease progression.Methods Sixty healthy subjects,60 patients with chronic hepatitis B,60 patients with autoimmune liver disease,60 patients with cirrhosis and 60 patients with liver cancer from Heze Municipal Hospital from June,2022 to December,2023 were selected as the study objects.Serum CHI3L1 expression levels of all subjects were detected by enzyme-linked immunoadsorption(ELISA)method.The expression level of cytokines was detected by flow cytometry.Biochemical analyzer was used to measure the level of biochemical indexes.Results CHI3L1 level measure showed pattern as follows:health examination group(47.00±20.50ng/mL)<CHB group(91.75±35.58ng/mL)<AILD group(128.30±41.92 ng/mL)<LC group(131.29±46.52ng/mL)<HC group(154.07±59.92ng/mL).ROC curve of CHI3L1 for LC diagnosis had an AUC of 0.965.ROC curve for CHI3L1 diagnosis of HC had an AUC of 0.974.If chronic hepatitis B group was used as control,AUC of CHI3L1 in the diagnosis of cirrhosis was 0.749(P<0.001),and that of CHI3L1+AST in the diagnosis of cirrhosis was 0.845(P<0.001),which was better than that of CHI3L1 alone.In chronic hepatitis B group,AUC for AFP diagnosis was 0.783,and that for CHI3L1 diagnosis was 0.800(P<0.001).AUC of CHI3L1+AFP in the diagnosis of HC was 0.891,and that of CHI3L1+AST+IL-17+IL-6 in the diagnosis of HCC was 0.937(P<0.001),which was better than that of CHI3L1 and AFP.Conclusion Serum CHI3L1 expression level is the highest in liver cancer group and the lowest in chronic hepatitis B group,and serum CHI3L1 expression level increases with disease progression.Serum CHI3L1 can be used as a non-invasive index in the diagnosis of liver cirrhosis and liver cancer.Serum CHI3L1,AST,IL-6,IL-17,IL-8,IFN-γcombined detection can improve the diagnosis of liver cirrhosis and liver cancer.