慢性乙型肝炎病毒感染患者血清sPD-1检测的临床意义  

Detection and clinical significance of soluble programmed death factor-1 in patients with chronic viral hepatitis B

作　　者：黄雪平 王明霞 江丽凤[2] 陆玉萍 林志辉[1] HUANG Xueping;WANG Mingxia;JIANG Lifeng;LU Yuping;LIN Zhihui(Department of digestive internal medicine,Fujian Provincial Hospital,Provincial Clinical Medical College of Fujian Medical University,Fuzhou,Fujian 350001,China)

机构地区：[1]福建医科大学省立临床医学院,福建省立医院消化内科,福州350001 [2]中山大学附属第五医院医保科

出　　处：《福建医药杂志》2022年第3期8-11,共4页Fujian Medical Journal

基　　金：福建医科大学启航基金(2016QH108)。

摘　　要：目的探讨血清中可溶性程序性死亡因子-1(sPD-1)在慢性乙型肝炎病毒(HBV)感染患者中检测的临床意义。方法选择我院就诊的慢性HBV感染非肝癌患者41例(慢性HBV感染组)和乙型肝炎性肝癌(HCC)患者59例(HCC组),采用ELISA技术检测两组血清sPD-1的水平。比较sPD-1在慢性HBV感染组和HCC组之间及HCC组肝癌手术前后差异,分析慢性HBV感染患者sPD-1水平与性别、年龄、抗病毒治疗等因素的关系。结果慢性HBV感染患者血清sPD-1为94.0(85.0,128.0)pg/mL,而乙型肝炎性肝癌患者血清sPD-1为28(9.0,44.5)pg/mL,差异有统计学意义(P<0.001)。sPD-1在肝癌与HBV感染非肝癌患者之间具有明显鉴别作用,其截断值为63 pg/mL(AUC:0.916,P<0.001)。肝癌患者sPD-1水平从切除前的106(43,120)pg/mL下降至切除后2天的91(34,100)pg/mL,差异有统计学意义(P<0.001)。慢性HBV感染抗病毒组sPD-1水平[(111.37±59.13)pg/mL]明显低于未抗病毒组[(306.09±59.13)pg/mL],差异有统计学意义(P=0.025)。慢性HBV感染sPD-1水平与年龄呈负相关(r=-0.82,P<0.05),与性别等其他因素无明显关联(P>0.05)。结论sPD-1在慢性HBV感染和肝癌的发生中可能发挥了一定的作用;监测血清sPD-1值,可能有助于预测乙型肝炎性肝癌的发生,对肝癌有鉴别诊断的价值。Objective To investigate the clinical significance of serum soluble programmed death-1(sPD-1)detection in patients with chronic hepatitis B virus(HBV)infection.Methods A total of 41 patients with chronic HBV infection without liver cancer(chronic HBV infection group)and 59 patients with HBV-induced hepatic carcinoma(HCC group)who were treated in our hospital were selected,and the serum sPD-1 levels in the two groups were detected by ELISA.sPD-1 of chronic HBV infection group and HCC group,as well as that before and after surgery in HCC group were compared,and the relationship between sPD-1 level and gender,age,antiviral therapy and other factors in patients with chronic HBV infection was analyzed.Results The serum sPD-1 of patients with chronic HBV infection was 94.0(85.0,128.0)pg/mL,while the serum sPD-1 of patients with HCC was 28(9.0,44.5)pg/mL,the difference was statistically significant(P<0.001).sPD-1 has a distinct role in discriminating between HCC and HBV-infected non-HCC patients,with a cut-off value of 63 pg/mL(AUC:0.916,P<0.001).The level of sPD-1 in patients with HCC decreased from 106(43,120)pg/mL before resection to 91(34,100)pg/mL two days after resection,and the difference was statistically significant(P<0.001).The level of sPD-1 in the antiviral group of chronic HBV infection(111.37±59.13)pg/mL〗was significantly lower than that in the non-antiviral group(306.09±59.13)pg/mL,and the difference was statistically significant(P=0.025).The level of sPD-1 in chronic HBV infection was negatively correlated with age(r=-0.82,P<0.05),and had no significant correlation with other factors such as gender(P>0.05).Conclusion sPD-1 may play a certain role in the occurrence of chronic HBV infection and HCC.Monitoring serum sPD-1 value may help to predict the occurrence of HCC and has the value of differential diagnosis of HCC.

关 键 词：可溶性程序性死亡因子-1 乙型肝炎 肝癌 抗病毒 

分 类 号：R512.62[医药卫生—内科学]