| Objective To investigate the clinical value of Golgi protein 73(GP73)and hyaluronic acid(HA)in the diagnosis of the progression of hepatitis B virus(HBV)-related chronic liver diseases.Methods:A total of 142 patients who visited The Affiliated Hospital of Qingdao University from December 2016 to April 2017 were enrolled,and among these patients,36 had hepatocellular carcinoma(HCC)with liver cirrhosis,66 had hepatitis B cirrhosis(LC),and 40 had chronic hepatitis B(CHB).A total of 30 healthy subjects who underwent physical examination during the same period of time were enrolled as control group.ELISA was used to measure the serum level of GP73,and chemiluminescence was used to measure the level of HA.Chemiluminescence immunoassay was used to measure HBeAg.ALT,AST,TBIL,ALB were measured by biochemical analyzer.The results were analyzed by SPSS.The correlation between GP73,HA and other makers were analyzed by Spearman correlation analysis.A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups;the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups,and the Mann-Whitney U test was used for further comparison between any two groups.The receiver operatingcharacteristic(ROC)curve was used to analyze the diagnostic value of GP73 and HA measured alone or in combination.The Z test was used for comparison of area under the ROC curve(AUC),and the chi-square test was used for comparison of sex ratio,sensitivity,and specificity.Results:(1)The CHB group,LC group,and HCC group had significantly higher serum levels of GP73 and HA than the control group(all P<0.05).The LC group and the HCC group had significantly higher serum levels of GP73 and HA than the CHB group(U=677,637,291,and 193,all P<0.05).In the LC group,the patients with decompensated liver cirrhosis had significantly higher serum levels of GP73 and HA than those with compensated liver cirrhosis(U=171 and 212,both P<0.05).The level of GP73 in moderate-severe chronic hepatitis group was higher than that in mild chronic hepatitis group(P<0.05).The level of GP73 in HBeAg-positive chronic hepatitis group was higher than that of HBeAg-negative chronic hepatitis group(P<0.05).(2)As for CHB patients,combined measurement of GP73 and HA had significantly higher AUC and sensitivitythan GP73measuredalone(AUC:0.950vs0.790,Z=2.32,P<0.05;sensitivity:91.70%vs 72.20%,?2=5.14,P<0.05).In the diagnosis of liver cirrhosis,GP73 had a significantly higher sensitivity than HA(87.90%vs 69.70%,?2=6.05,P<0.05),and compared with HA measured alone,combined measurement of GP73 and HA had a significant reduction in specificity(62.30%vs 86,80%,?2=14.60,P<0.05)and a significant increase in sensitivity(93.90%vs 69.70%,?2=11.80,P<0.05).In the diagnosis ofdecompensated liver cirrhosis,combined measurement of GP73 and HA a significantly higher sensitivity than HA measured alone(83.80%vs 67.60%,?2=4.17,P<0.05).GP73,HA,and alpha-fetoprotein(AFP)had an AUC of 0.549,0.525,and 0.807,respectively,in the diagnosis of HCC,and GP73 and HA had alower diagnostic value than AFP(Z=3.49 and 3.80,both P<0.05).(3)GP73 had positive correlations with ALT,AST(r= 0.591,0.562,P<0.05)in CHB group.GP73 and HA had negative correlations with ALB(r=-0.694,-0.553,P<0.05).Conclusion:(1)GP73 and HA can help with the monitoring of the progression of HBV-related chronic liver diseases.Combined measurement of GP73 and HA has an important clinical value in the diagnosis of liver cirrhosis and decompensated liver cirrhosis.Serum GP73 and HA fail to distinguish HCC from cirrhotic patients when compared with AFP.(2)The level of GP73 in chronic hepatitis B patients may be correlated with HBV replication.GP73 and HA can reflect the degree of liver function damage and liver synthesis function of chronic hepatitis B patients. |
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