血清外纺锤体极样蛋白1(ESPL1)在HBV相关肝纤维化进程中的诊断价值  

Diagnostic value of serum extra-spindle pole-like protein 1 in the progression of hepatitis B virus-related liver fibrosis

作　　者：黄龙 梁红倩 任澳丽 苏明华[1] 胡伯斌 黎清梅 苏土梅 殷倩冰 冯彦菲 江建宁[1] HUANG Long;LIANG Hongqian;REN Aoli;SU Minghua;HU Bobin;LI Qingmei;SU Tumei;YIN Qianbing;FENG Yanfei;JIANG Jianning(Department of Infectious Diseases,The First Affiliated Hospital of Guangxi Medical University,Key Laboratory of High-Incidence-Tumor Prevention and Treatment,Ministry of Education,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院感染性疾病科,教育部区域性高发肿瘤早期防治研究重点实验室,南宁530021

出　　处：《临床肝胆病杂志》2024年第9期1785-1789,共5页Journal of Clinical Hepatology

基　　金：国家自然科学基金(81960115,82260124,82160123);区域性高发肿瘤早期防治研究教育部重点实验室自主研究项目(GKE-ZZ202107);广西区域性高发肿瘤早期防治研究重点实验室自主研究项目(GKE-ZZ202218)。

摘　　要：目的探讨外纺锤体极样蛋白1(ESPL1)检测对HBV相关肝纤维化进程的临床诊断价值。方法选取2017年6月—2023年8月广西医科大学第一附属医院收治的HBV感染者228例,采用瞬时弹性成像系统FibroScan检测患者的肝硬度值(LSM),并根据LSM值分为无肝纤维化组(n=80)、轻度肝纤维化组(n=83)、进展期肝纤维化组(n=30)和肝硬化组(n=35)。采用酶联免疫吸附试验(ELISA)检测各组血清中的ESPL1水平。采用Kruskal-Wallis H检验比较4组患者血清ESPL1水平的差异;Spearman相关性分析方法比较ESPL1与LSM值的相关性;运用受试者工作特征(ROC)曲线分析血清ESPL1对不同肝纤维化进程的预测价值。结果肝硬化组血清ESPL1水平高于无肝纤维化组、轻度肝纤维化组(P值均<0.05),进展期肝纤维化组、轻度肝纤维化组血清ESPL1水平高于无肝纤维化组(P值均<0.05)。相关性分析显示:不同肝纤维化程度HBV感染者血清ESPL1与LSM值呈正相关(r=0.515,P<0.001);血清ESPL1预测肝硬化和进展期肝纤维化的曲线下面积分别为0.809和0.638,敏感度分别为87.5%和100%,特异度分别为59.7%和31.3%。结论血清ESPL1与HBV相关肝纤维化存在一定的相关性,血清ESPL水平越高可能提示肝纤维化程度越高;血清ESPL1可望成为辅助诊断肝硬化的血清标志物之一和动态监测HBV感染者肝纤维化进程的重要临床方法。Objective To investigate the clinical diagnostic value of extra-spindle pole-like protein 1(ESPL1)in the progression of hepatitis B virus(HBV)-related liver fibrosis.Methods A total of 228 patients with HBV infection who were admitted to The First Affiliated Hospital of Guangxi Medical University from June 2017 to August 2023 were enrolled.The transient elastography system FibroScan was used to determine liver stiffness measurement(LSM)for all patients,and according to the LSM value,they were divided into non-liver fibrosis group with 80 patients,mild liver fibrosis group with 83 patients,advanced liver fibrosis group with 30 patients,and liver cirrhosis group with 35 patients.ELISA was used to measure the serum level of ESPL1.The Kruskal-Wallis H test was used for comparison of the serum level of ESPL1 between the four groups;the Spearman correlation analysis was used to investigate the correlation between ESPL1 and LSM;the receiver operating characteristic(ROC)curve was used to analyze the value of serum ESPL1 in predicting the progression of liver fibrosis.Results The liver cirrhosis group had a significantly higher serum level of ESPL1 than the non-liver fibrosis group and the mild liver fibrosis group(both P<0.05),and the advanced liver fibrosis group and the mild liver fibrosis group had a significantly higher serum level of ESPL1 than the non-liver fibrosis group(both P<0.05).The correlation analysis showed that there was a positive correlation between serum ESPL1 and LSM in the patients with HBV infection and varying degrees of liver fibrosis(r=0.515,P<0.001).Serum ESPL1 had an area under the ROC curve(AUC)of 0.809 in predicting liver cirrhosis and an AUC of 0.638 in predicting advanced liver fibrosis,with a sensitivity of 87.5%and 100%,respectively,and a specificity of 59.7%and 31.3%,respectively.Conclusion There is a certain correlation between serum ESPL1 and HBV-related liver fibrosis,and higher serum ESPL1 may indicate a higher degree of liver fibrosis.Serum ESPL1 is expected to become one of the ser

关 键 词：乙型肝炎病毒 肝纤维化 外纺锤体极样蛋白1 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]