Lumipulse HBsAg-HQ与Architect HBsAg-QT定量的一致性及其预测慢性乙型肝炎肝组织病理状态的效能  

Consistency between quantitative Lumipulse HBsAg-HQ and Architect HBsAg-QT, and their predictive efficacy on liver tissue pathological state of chronic hepatitis B

作　　者：张占卿[1] 陆伟[1] 周新兰[1] 王雁冰[1] 丁荣蓉[1] 黄丹[1] 李秀芬[1] Zhang Zhanqing;Lu Wei;Zhou Xinlan;Wang Yanbing;Ding Rongrong;Huang Dan;Li Xiufen(Division Ⅱ of Hepatology Department, Shanghai Public Health Clinical Center of Fudan University, Shanghai 201508, China)

机构地区：[1]上海市公共卫生临床中心肝炎二科,上海201508

出　　处：《中华实验和临床感染病杂志（电子版）》2017年第5期447-454,共8页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：上海市卫生和计划生育委员会重点科研项目(No.20134032);国家"十二五"传染病科技重大专项(No.2013ZX10002005)

摘　　要：目的探讨血清Lumipulse HBsAg-HQ与Architect HBsAg-QT定量的一致性及其预测慢性乙型肝炎肝组织病理状态的效能。方法选取147例HBe Ag阳性和128例HBe Ag阴性患者。HBsAg-HQ采用化学发光酶免疫法和Fujirebio Lumipulse G1200全自动化学发光免疫系统检测,HBsAg-QT采用化学发光微粒子免疫法和Abbott Architect I 2000全自动化学发光免疫系统检测。肝组织病理学诊断采用Scheuer评分系统。数据处理和统计分析Medcalc 15.1软件。结果血清HBsAg-QT<100 000 m IU/ml患者,血清HBsAg-HQ与HBsAg-QT呈显著正相关(r=0.861,P<0.001),血清HBsAg-HQ与HBsAg-QT总体不一致率为6.45%(2/31);血清HBsAg-QT≥100 000 m IU/ml患者,血清HBsAg-HQ与HBsAg-QT呈显著正相关(r=0.929,P<0.001),血清HBsAg-HQ与HBsAg-QT总体不一致率为0.25%(6/244)。HBe Ag阳性患者,血清HBsAg-HQ和HBsAg-QT预测病理学分级≥G2、≥G3和分期≥S2、≥S3、≥S4的ROC曲线下面积与对角参考下面积之间的差异均具有统计学意义(P均<0.05),其中预测病理学分期≥S4的ROC曲线下面积最大;血清HBsAg-HQ与HBsAg-QT预测肝组织相同病理状态的ROC曲线下面积间差异均无统计学意义(P均>0.05);血清HBsAg-HQ和HBsAg-QT预测病理学分期≥S4的最佳截断值分别为7.328×106 m IU/ml和6.194×106 m IU/ml,其对应的灵敏度、特异度分别为81.25%和75.00%、64.35%和67.83%。结论血清HBsAg-HQ与HBsAg-QT有高度的相关性和一致性,血清HBsAg-HQ和HBsAg-QT对HBe Ag阳性患者病理学分期≥S4有一定预测意义。Objective To investigate the consistency between quantitative Lumipulse HBsAg-HQ and Architect HBsAg-QT, and their predictive efficacy on liver tissue pathological state of chronic hepatitis B. Methods Total of 147 patients with HBeAg-positive and 128 patients with HBeAg-negative were enrolled, respectively. Serum HBsAg-HQ was measured by chemiluminescence enzyme immunoassay and Lumipulse G1200 automatic chemiluminescence immunoassay analyzer, while serum HBsAg-QT was measured by chemiluminescence microparticle immunoassay and Abbott Architect I 2000 automatic chemiluminescence immunoassay analyzer. The Scheuer score system was used for pathological diagnosis of liver tissue. Medcalc software 15.1 was used for data processing and statistical analysis. Results Among the patients with serum HBsAg-QT less than 100000 mIU/ml, serum HBsAg-HQ was positively correlated significantly with HBsAg-QT （r = 0.861, P 〈 0.001）, and the overall＆amp;nbsp;disagreement rate between quantitative HBsAg-HQ and HBsAg-QT was 6.45% （2/31）. Among the patients with serum HBsAg-QT more than or equal to 100000 mIU/ml, serum HBsAg-HQ was positively correlated significantly with HBsAg-QT （r = 0.929, P 〈 0.001）, and the overall disagreement rate between quantitative HBsAg-HQ and HBsAg-QT was 0.25% （6/244）. Among the patients with HBeAg-positive, the areas under ROC of serum HBsAg-HQ and HBsAg-QT for predicting ≥ G2, ≥ G3 of pathological grade and ≥ S2, ≥S3, ≥ S4 of pathological stage were significantly larger than the area under diagonal reference （all P 〈 0.05）, in which the area under ROC of serum HBsAg-HQ and HBsAg-QT for predicting ≥ S4 was the largest. The differences between the area under ROC of serum HBsAg-HQ and HBsAg-QT for predicting the same pathological states were not significantly different. The optimal cutoffs of serum HBsAg-HQ and HBsAg-QT for predicting ≥ S4 were 7.328 × 106 mIU/ml and 6.194 × 106 mIU/ml, and the corresponding sensitivity and specificity were 81.25% and 64.35%, 75% a

关 键 词：乙型肝炎表面抗原 全自动化学发光免疫系统 肝组织 病理学 无创诊断 

分 类 号：R512.62[医药卫生—内科学]