| Objective To observe the changes of serum Golgi protein 73(GP73),liver stiffness parameter,transaminase level and liver histology before treatment and after 48 weeks treatment for HBV-infected patients with chronic liver disease,and to investigate the expression of GP73 in patients with HBV-infected chronic liver disease.The predictive value of improved liver fibrosis after antiviral therapy.Methods(1)A total of 115 patients with chronic hepatitis B(CHB)and liver cirrhosis(LC)who were admitted to the Department of Infectious Diseases,General Hospital of Ningxia Medical University from December 2015 to December 2018 were enrolled,including34 mild,22 moderate,26 severe and 33 liver cirrhosis.All patients had not received antiviral therapy.(2)Serum GP73 levels were measured by Enzyme-linked immunosorbent assay(ELISA);All patients underwent liver biopsy,determining the inflammatory activity grade and fibrosis stage of liver tissue inflammation;Liver elasticity tester(Fibroscan,FS)The liver stiffness parameter was measured;94 patients were treated with liver biopsy for 48 weeks.The levels of GP73 in liver tissue were detected by immunohistochemistry(IHC);(3)Using SPSS 21.0 statistical software was used to analyze whether there were statistical differences in serum GP73,transaminase,and liver stiffness parameter before treatment and after treatment for 48 weeks.To investigate the correlation between the expression of serum GP73,liver tissue GP73 and hepatic fibrosis and liver stiffness parameter before treatment and after48 weeks;The receiver operating characteristic curve(ROC)was used to analyze the value ofserum GP73 and liver stiffness parameter in predicting the stage of liver fibrosis.The inflammatory activity grade and fibrosis stage changes of liver tissue and the expression of GP73 in liver tissue were analyzed before and after treatment for 48 weeks.Results(1)The serum GP73 was(76.19±40.43)ng/ml,(58.01±33.67)ng/ml,before and 48 weeks after antiviral therapy.The liver stiffness parameter were(10.79±6.68)kPa and(8.60±4.77)kPa,ALT were(95.53±102.61)U/L,(43.42±40.94)U/L,AST were(79.57±85.06)U/L and(39.13±28.82)U/L,After treatment for 48 weeks,each index was significantly lower than before treatment.(p=0.001,p=0.004,p=0.000,p=0.000).(2)The expression of GP73 in serum and liver tissue was positively correlated with the stage of hepatic fibrosis and liver stiffness parameter before treatment(r=0.364,0.556,0.216,0.361,p=0.000,0.000,0.035,0.000).After treatment for 48 weeks,the expression of GP73 in serum and liver tissue was correlated with the stage of hepatic fibrosis.There was also a positive correlation between liver stiffness parameter(r=0.556,0.527,0.433,0.418,p=0.000,0.000,0.000,0.000).(3)When the serum GP73 was 45.86 ng/ml,the area under the curve was 0.518,the sensitivity was 52.1%,the specificity was 54.4%,p>0.05,it means the predicted value was not significant.When serum GP73 was 66.08 ng/ml and 95.52 ng/ml,the area under the corresponding curve was 0.734 and 0.786,respectively,and the sensitivity was 72.3% and78.2%,respectively,and the specificities were 77.1% and 80.7%,respectively.It is suggested some reference value for predicting S?3 and S=4.When the liver stiffness parameter were8.35 kPa,12.13 kPa and 15.68 kPa,the areas under the corresponding curves were 0.671,0.830 and 0.912,and the sensitivities were 68.3%,79.6% and 91.3%,and the specificities were 66.5%,76.9% and 91.3%,suggesting some reference value for predictions S?2,S?3 and S=4.(4)There were 34 cases in the mild group,22 cases in the moderate group,26 cases in the severe group,and 33 cases in the cirrhosis group.The corresponding serum GP73 were(45.64±14.54)ng/ml,(68.80±36.22)ng/ml,(85.29±35.98)ng/ml,(105.45±40.27)ng/ml,There was a statistically significant difference between the groups(p<0.05).The serum GP73 levels were(41.12±15.19)ng/ml,(54.36±28.41)ng/ml,(62.45±32.04)ng/ml,(87.53±33.69)ng/ml after treatment for 48 weeks,respectively.There was a statistically significant difference between the groups(p<0.05).The changes of serum GP73 in the same group before and after treatment were analyzed.The results showed that there was no significant difference between the mild group and the moderate group before treatment(p>0.05).The severe group and the liver cirrhosis group were significantly lower than before treatment(p<0.05).(5)Before treatment,the grade of hepatic inflammatory activity was 41 G1(35.65%),31G2(26.96%),28 G3(24.35%),15 G4(13.04%),and after treatment for 48 weeks there is 52G1(55.32%),25 G2(26.60%),9 G3(9.57%),8 G4(8.51%).The hepatic fibrosis stage was S0 34 cases(29.56%),S1 23 cases(20.00%),S2 24 cases(20.87%),S3 23 cases(20.00%),S411 cases(9.57%),and after treatment for 48 weeks there were 40 cases(42.56%)in S0,21cases(22.34%)in S1,14 cases(14.89%)in S2,11 cases(11.70%)in S3,and 8 cases(8.51%)in S4.The stage of hepatic fibrosis and the grade of hepatic inflammatory activity were significantly improved after treatment(p<0.024,p<0.002).(6)The expression of GP73 in liver tissue before treatment was negative in 24 cases(20.87%),weakly positive in 17 cases(14.78%),moderately positive in 47 cases(40.87%),strongly positive in 27 cases(23.48%),and after treatment for 48 weeks the expression of GP73 in liver tissue was negative in 29 cases(30.85%),weakly positive 28 cases(29.79%),moderately positive 23 cases(24.47%),and strongly positive 14 cases(14.89%).The expression of GP73 in liver tissue after treatment was significantly lower than that before treatment(p=0.003).Conclusion The GP73 may be associated with the outcome of the illness is related with patients.Dynamic monitoring of serum GP73 may have certain reference value for assessing fibrosis in chronic liver disease. |
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