血清自身抗体在乙肝肝纤维化分期中的诊断价值研究  

Study on the diagnostic significance of level of serum autoantibodies in fibrosis staging in patients with chronic HBV hepatitis

作　　者：何肖敏[1] 李斯文[1] 吕婷霞 张蓓[1] 黄坚[1] 

机构地区：[1]首都医科大学附属北京友谊医院科研实验中心,北京100050

出　　处：《临床和实验医学杂志》2016年第7期632-636,共5页Journal of Clinical and Experimental Medicine

基　　金：王宝恩肝纤维化基金(编号20140030)

摘　　要：目的分析一组血清自身抗体在乙肝肝纤维化中的诊断价值。方法通过蛋白芯片技术将8种自体抗原蛋白即着丝粒蛋白(CENPF)、氨基酰化酶1(ACY1)、热休克蛋白76(HSP76)、烯醇化酶(ENO1)、过氧化物酶Ⅲ(PRO3)、三组氨酸核苷结合蛋白(HINT1)、钙调蛋白(RGN)和凋亡诱导因子(AIF)制成蛋白芯片,然后检测250例不同分期的慢性乙肝肝纤维化患者和100例健康体检人群血清中上述自体抗原对应的自身抗体水平。通过独立样本t检验比较不同分期肝纤维化患者的自身抗体平均值,通过χ2检验比较不同分期肝纤维化患者自身抗体阳性率。结果在8种自体抗原蛋白中,CENPF血清自身抗体水平随肝纤维化分期加重呈逐渐升高的趋势,S01/S4和S23/S4间均有统计学差异(P<0.05),但S01/S23间无统计学差异,AUC值分别为0.648、0.641和0.505,敏感度和特异度分别为54.9%/74.0%、54.9%/74.0%和85.9%/24.7%。ACY1自身抗体阳性率在S01/S23,S01/S4和S23/S4之间均有显著性差异(P<0.05)。ENO1自身抗体阳性率在S01/S4和S23/S4之间也存在统计学差异(P<0.05)。联合检测CENPF与ACY1区分S01/S4及S23/S4的AUC值分别为0.692和0.698。结论血清自身抗体标志物在区分不同分期的肝纤维化患者中具有一定的价值,尤其是CENPF、ACY1和ENO1自身抗体,为肝纤维化分期提供了一种新的诊断方法,值得进一步研究。Objective To analyze the diagnostic significance of several kinds of serum autoantibodies in HBV related liver fibrosis. Methods Protein chips were prepared by using eight autoantigens as centromere protein F（ CENPF）,aminoacylase- 1（ ACY1）,heat shock protein76（ HSP76）,alpha- enolase（ ENO1）,class Ⅲ peroxidase（ PRO3）,histidine triad nucleotide binding protein 1（ HINT1）,regucalcin（ RGN）and apoptosis- inducing factor（ AIF） which had screened in our previous study,then levels of serum autoantibodies in 250 patients with HBV related liver fibrosis at different stages and 100 healthy controls were determined. Receiver- operating characteristic curve（ ROC） had been applied to analyze the best diagnostic cut off value of these autoantibodies and their sensitivity and specificity. The average levels of autoantibody at different stages of liver fibrosis were compared by T- test,and the prevalence of positive autoantibody was analyzed by using chi- squared（ χ2） test with Yate＇s correction. Results Among evaluation of these eight autoantigens,the level of CENPF autoantibody had been raised along with the progress of liver fibrosis,patients at S01 / S4 and S23 / S4 stages showed significant difference in signal intensity（ P〈0. 05）,but the difference between S01 and S23 showed no statistical significance,the values of area under ROC curve（ AUC） were 0. 648,0. 641 and 0. 505 respectively,and their rates of sensitivity and specificity were 54. 9% /74. 0%,54. 9% /74. 0% and 85. 9% /24. 7% respectively. The prevalence of positive ACY1 autoantibody showed significant difference between patients at S01 / S23,S01 / S4 and S23 / S4 stages（ P〈0. 05）. The prevalence of ENO1 autoantibody also showed statistical difference between patients at S01 / S4 and S23 / S4 stages（ P〈0. 05）. The AUC values of combined CENPF and ACY1 for discrimination of S01 / S4 and S23 / S4 were 0. 692 and 0. 698 respectively. Conclusion The serum autoantibody biomarkers may have certain value in d

关 键 词：肝纤维化 血清标志物 自身抗体 

分 类 号：R512.62[医药卫生—内科学]