血清透明质酸对慢性肝炎病理分级与分期的诊断价值

Diagnostic Value of Serum Hyaluronic Acid for Hepatic Pathologic Grading and Staging in Patients with Chronic Hepatitis

目的 探讨血清透明质酸 (hyaluronicacid ,HA)对慢性肝炎病理分级与分期的诊断价值。方法 血清HA采用放射免疫法检测 ;血清HA对慢性肝炎病理分级与分期诊断价值的评价采用受试者工作特征曲线法。结果 血清HA水平在S2 与S1和G2 与G1之间差异无显著性 (P =0 .65 11和P =0 .82 15 ) ,在S3 S4 与S2 和G2 与G1之间差异有显著性 (P =0 .0 0 62和P =0 .0 892 )。血清HA对S2 与S1和G2 与G1无鉴别价值 ;以血清HA≥ 190ng/ml为分界点鉴别S3 S4 与S2 ,其灵敏度、特异度和准确度分别为 72 .7%、70 .8%和 71.4% ,阳性和阴性预测值分别为5 3 .3 %和 85 .0 % ;以血清HA≥ 2 85ng/ml为分界点鉴别G3与G2 ,其灵敏度、特异度和准确度分别为 71.4%、83 .3 %和 81.1% ,阳性和阴性预测值分别为 5 0 .0 %和 92 .6%。

Objective To explore the diagnostic value of serum hyaluronic acid for hepatic pathologic staging and grading of chronic hepatitis.Methods Serum HA was determined by radioimmunoassay.The diagnostic value of serum for hepatic pathologic staging and grading was evaluated by receiver operator characteristic curve.Results There was no significant difference in serum HA level between S 2 and S 1 , and between G 2 and G 1 .Serum HA level in S 3-S 4 and G 3 was notably higher than that in S 2 and G2 ,respectively.There was no differential value of serum HA for differentiating S 2 from S 1 and G 2 from G 1;taking serum HA≥190 ng/ml as cut-off for differentiating S 3-S 4 from S 2,the sensitivity,specificity and accuracy rate were 72.7%,70.8% and 71.4% respectively,the positive and negative predictive value were 53.3% and 85.0% respectively;taking serum HA≥285 ng/ml as cut-off for differentiate G 3 and G 2,the sensitivity,specificity and accuracy rate were 71.4%,83.3% and 81.1% respectively,the positive and negative predictive value were 50.0% and 92.6% respectively.Conclusion There is a certain value of serum HA for differentiating severe from mild pathologic staging and grading.