| Objective: To investigate the clinical significance of serum alpha-fetoprotein in predicting hepatic inflammation and hepatic fibrosis in patients with chronic hepatitis B.Methods: 286 patients with chronic hepatitis B who were selected from our hospital from 2015 to 2017 and 150 healthy people were selected as healthy control group.Hematological indicators include Platelet(PLT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),albumin(ALB),globulin(GLB),alkaline phosphatase(ALP),glutamyltranspeptidase(?-GGT),alpha-fetoprotein(AFP),HBV-DNA,hepatitis B surface antigen(HBs Ag)also should be detected.SPSS16.0 software was used for statistical analysis.Measured data with normal distribution were expressed as mean ± standard deviation.Independent group t test was used for comparison between groups.Measured data with non-normal distribution were expressed in median [Quartiles(P25,P75)].Mann-whitney U and Kruskal-Wallis tests were used for comparison between groups.Both were considered statistically significant at P < 0.05.significance.The rank-sum test Spearman correlation analysis was used to analyze the correlation between AFP and clinical indicators.Binomial logistic regression analysis was used to analyze the relationship between patient indicators and hepatic inflammation.The receiver operating characteristic curve(ROC curve)was used to assess the sensitivity and specificity of serum AFP levels in predicting hepatic inflammation and hepatic fibrosis.Results: Serum AFP levels in 286 patients with chronic hepatitis B were positively correlated with the degree of liver fibrosis(r = 0.373,P <0.0001).The content of AFP in patients with chronic hepatitis B were significantly higher than that in healthy controls(P <0.05).The serum levels of AFP in patients with significant fibrosis(S2,S3,S4)were obviously higher than those in patients with non-significant fibrosis(S0,S1),(P<0.05).The levels of serum AFP in patients with chronic hepatitis B were positively correlated with HBV-DNA,and the values of coefficient is r = 0.231(P = 0.008).However,the correlation did not exist between and HBs Ag.The levels of serum AFP were positively correlated with APRI,the correlation coefficients were,r = 0.342(P<0.0001),the difference was statistically significant.The significance of specificity and sensitivity to predict hepatic fibrosis in the subject's working curve(ROC curve)C were84.92%? 37.41%.The activity of different liver inflammation was divided into two groups,namely G<2 group and G?2 ? group.The difference of ALB,GLB,TBIL,ALT,AST,ALP and ?-GGT between the two groups were analyzed.Among the indexes except ALB,there were significant differences among groups(P=0.002,0.023,0.000,0.000,0.000,0.000).Serum AFP levels in G?2 group was significantly higher than G<2 group,P <0.0001.There was no significant difference in serum AFP between HBe Ag-negative and CHB patients,P = 0.502.AFP showed a positive correlation with GLB,TBIL,ALT,AST,ALP and ?-GGT(r=0.314,0.322,0.361,0.411,0.416,0.503,P=0.000,0.000,0.000,0.000,0.000,0.000,0.000),while AFP was negatively correlated with ALB(r =-0.378,P = 0.000).The specificity and sensitivity of AFP,ALT,AST and?-GGT in the diagnosis of significant liver inflammation were analyzed by ROC curve.The area under the curve was 0.874(95% confidence interval: 0.839-0.904),0.846(95% confidence interval Range: 0.808-0.878),0.674(95% confidence interval:0.628-0.718)and 0.576(95% confidence interval: 0.528-0.623),the difference was statistically significant.The predictive significance of AFP for liver inflammation activity was higher than other The index of liver inflammation was 2.5ng/ml,its specificity and sensitivity of diagnosing liver significant inflammation were 93.33% and70.28% respectively.Conclusion: Serum AFP levels in patients with chronic hepatitis B gradually increase with the level of liver fibrosis,which has the clinical significance of evaluating the patients with significant hepatic fibrosis. |
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