苏州地区HBV感染患者血清中乙型肝炎核心相关抗原表达特点分析

An Analysis of Expression Characteristics of Hepatitis B Core-associatedAntigen in Serum Samples of HBV Infected Patients in Suzhou Area

目的探究乙型肝炎核心相关抗原(hepatitis B core-related antigen,HBcrAg)在乙型肝炎病毒感染患者血清中的表达特点,为HBcrAg在临床上的深入应用提供理论依据。方法本研究纳入200例因怀疑乙型肝炎病毒感染在苏州市第五人民医院就诊的患者为研究对象,均进行血清中HBcrAg、HBeAg和HBV DNA检测,对结果进行统计以及分组分析。结果以HBeAg、HBV DNA检测结果为参考标准进行比较,HBcrAg检测的灵敏度为82.8%,特异性为89.7%,阴性/阳性总体符合率为86.5%,具有较好的一致性(Kappa=0.728,95%CI 63.2%~82.3%),且阳性检出率为3者中最高。对不同表型患者的分组研究发现,HBeAg/HBV DNA双阳性患者血清中HBcrAg的阳性检出率和表达量均最高。在不同乙肝两对半模式患者中,135阳性患者血清中HBcrAg的阳性检出率和表达量均显著高于145阳性及其他模式患者,且HBcrAg的表达量与HBV DNA的表达量具有较好的正相关性(r=0.81,P<0.001)。结论HBcrAg是一种可靠的反映HBV病毒复制状态的新型标志物,且在HBeAg/HBV DNA双阳性患者和乙肝两对半135阳性患者血清中阳性检出率和表达量较高,这些特征能为HBcrAg在临床上进一步的深入应用丰富理论基础,为临床上评估HBV感染患者治疗效果及判断治疗终点等提供参考价值。

Objective To explore the expression characteristics of hepatitis B core-related antigen(HBcrAg)in serum samples of hepatitis B virus infected patients,so as to provide a theoretical basis for the in-depth clinical application of HBcrAg.Methods 200 patients with suspected hepatitis B virus infection in Suzhou Fifth People’s Hospital were included in this study.Serum HBcrAg,HBeAg and HBV DNA were detected in all patients and the results were analyzed statistically among defined groups.Results Using HBeAg and HBV DNA test results as reference standards,the sensitivity and specificity of HBcrAg detection were 82.8%and 89.7%,respectively,while the overall negative/positive coincidence rate was 86.5%,showing a good consistency(Kappa=0.728,95%CI 63.2%-82.3%).Its positive detection rate was the highest among the three markers.The group study of patients with different phenotypes showed that HBeAg/HBV DNA double positive patients had the highest positive rate and expression of HBcrAg in serum samples.The positive detection rate and expression level of HBcrAg in serum of 135-positive patients were significantly higher than those of 145-positive patients and patients with other modes,while the expression level of HBcrAg was positively correlated with the expression level of HBV DNA(r=0.81,P<0.001).Conclusion HBcrAg could serve as a reliable novel marker of HBV virus replication status,and has a higher positive detection rate and expression level in serum of HBeAg/HBV DNA double-positive patients and hepatitis B virus 135 positive patients.These characteristics can enrich the theoretical knowledge for further in-depth application of HBcrAg in clinical practice,and provide reference value for further clinical evaluation of treatment effect and judgment of treatment endpoint in patients with HBV infections.