肝硬化患者外周血甲胎蛋白与丙酮酸激酶M2和白蛋白mRNA的表达及临床意义  

Expression of peripheral α-fetoprotein,pyruvate kinase isoenzyme type M2 and albumin detection on liver cirrhosis and its clinical value

作　　者：童杨雯 张青 TONG Yang - wen ZHANG Qing(Department of Laboratory, People＇ s Hospital of East and West Lake District, Wuhan 430040, Chin)

机构地区：[1]武汉市东西湖区人民医院检验科,武汉430040

出　　处：《中国临床药理学杂志》2017年第12期1094-1097,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然科学基金资助项目(30570070)

摘　　要：目的研究慢性乙型病毒性肝炎(乙肝)肝硬化患者外周血甲胎蛋白(AFP)、丙酮酸激酶M2(PKM2)、白蛋白(Alb)mRNA表达及其临床意义。方法选择89例慢性乙肝肝硬化患者作为肝硬化组,另选择60例健康人群作为对照组。肝硬化组按照血清HBV-DNA检测结果,再分为病毒复制组53例和非病毒复制组36例。抽取各组外周血5 mL,实时定量PCR法检测肝硬化组与对照组血浆AFP、PKM2、Alb mRNA表达水平。荧光定量PCR检测肝硬化患者血清HBV-DNA含量,分析血浆AFP、PKM2、Alb mRNA与HBV-DNA载量的相关性。根据AFP、PKM2、Alb mRNA相对表达量,绘制相应ROC曲线。结果肝硬化组AFP mRNA相对表达量为13.6±2.1,PKM2 mRNA为6.4±0.5,Alb mRNA为15.1±2.5。对照组分别为7.6±0.7,1.4±0.2,7.2±0.5,肝硬化组AFP、PKM2、Alb mRNA表达量显著高于对照组,差异有统计学意义(P<0.05)。病毒复制组AFP mRNA相对表达量为15.3±4.2,PKM2 mRNA为7.6±0.7,Alb mRNA为18.2±4.5。非病毒复制组分别为11.1±2.4,4.6±0.3,10.5±1.7,病毒复制组AFP、PKM2、Alb mRNA表达量显著高于非病毒复制组,差异有统计学意义(P<0.05)。相关性分析显示,AFP mRNA与HBV-DNA呈正相关(r=0.401,P<0.05),PKM2 mRNA与HBV-DNA呈正相关(r=0.380,P<0.05),Alb mRNA与HBV-DNA呈正相关(r=0.607,P<0.001)。AFP mRNA ROC曲线下面积为0.885,最佳临界值为8.7,对应的敏感度为84.9%,特异度为84.3%;PKM2 mRNA ROC曲线下面积为0.879,最佳临界值为3.4,对应的敏感度为84.1%,特异度为81.7%;Alb mRNA ROC曲线下面积为0.921,最佳临界值为9.5,对应的敏感度为88.1%,特异度为96.8%。结论肝硬化患者血浆AFP、PKM2、Alb mRNA表达显著增加,通过检测外周血AFP、PKM2及Alb mRNA可以为肝硬化诊断提供参考。Objective To explore the expression of peripheral mRNA expression level of α-fetoprotein（AFP）,pyruvate kinase isoenzyme type M2（PKM2）,albumin（Alb） in patients with liver cirrhosis and its clinical value. Methods A total of 89 cases of liver cirrhosis patients were selected as hepatocirrhosis groups,60 healthy people were selected as the control group. The 89 cases of liver cirrhosis group accorded to serum HBV-DNA detection results were divided into viral replication group（53 cases） and non viral replication group（36 cases）. The 5 mL of peripheral blood was extracted. Plasma mRNA expression level of AFP,PKM2,Alb were detected by real-time quantitative PCR in hepatocirrhosis group and control group. Serum HBV-DNA levels were detected by fluorescence quantitative PCR in hepatocirrhosis group. The correlation between plasma AFP,PKM2,Alb mRNA and HBV-DNA load was analyzed. And the corresponding ROC curves were drawn accorded to the relative expression of AFP,PKM2 and Alb mRNA. Results The AFP mRNA relative expression in hepatocirrhosis group was 13. 6 ± 2. 1,PKM2 mRNA was 6. 4 ± 0. 5,Alb mRNA was 15. 1 ± 2. 5; while that in control group were 7. 6 ± 0. 7,1. 4 ± 0. 2,7. 2 ± 0. 5 respectively. Compared with control group,it was significantly higher than that in control group（P〈0. 05）. AFP mRNA relative expression in viral replication group was 15. 3 ± 4. 2,PKM2 mRNA was 7. 6 ± 0. 7,Alb mRNA was 18. 2 ± 4. 5,and non viral replication group was 11. 1 ± 2. 4,4. 6 ± 0. 3,10. 5 ± 1. 7,respectively. The AFP,PKM2,ALB mRNA expression in viral replication group was significantly higher than that in non viral replication group（P〈0. 05）. Correlation analysis showed that AFP mRNA was positively correlated with HBV-DNA（r = 0. 401,P〈0. 05）,PKM2 mRNA was positively correlated with HBV-DNA（r = 0. 380,P〈0. 05）,and Alb mRNA was positively correlated with HBV-DNA（r = 0. 607,P〈0. 001）. To AFP,PKM2,ALB mRNA expression to draw the ROC curve,the results showed that AFP mRNA in RO

关 键 词：甲胎蛋白 丙酮酸激酶M2 白蛋白 肝硬化 

分 类 号：R975[医药卫生—药品]