| Objective: To investigate the relationship between serum levels of cytokeratin 18(CK18)M30 and M65 and different stages of patients with chronic hepatitis B virus(HBV)infection.The diagnostic values of CK18 M30 and M65 in HBV infection and disease progression was also evaluated.Methods: A total of 166 subjects who admitted to Qingdao municipal hospital from December 2015 to June 2016 were included in this study,including 33 healthy controls,24 inactive HBs Ag carriers,9 chronic HBV carriers,38 HBe Ag positive CHB patients,12 HBe Ag negative CHB patients and 50 cirrhosis patients.The differences of serum levels and positive rate of CK18 M30 and M65 among each group were compared,SPSS17.0 statistical software was used to analyze the indexes.P < 0.05 was considered statistically significant.This study mainly consists of four parts(1)explore the difference of CK18 M30 and M65 levels in each group,and explore the value of CK18 M30 and M65 in disease dignosis;(2)explore the levels of CK18 M30 and M65 in the HBV carriers,evaluate its sensitivity in the response of liver injury;(3)explore whether the CK18 M30 and M65 is involved in the development of HBV carriers to chronic hepatitis B.Furthermore,identify its role in the progression of disease.(4)Spearman correlation analysis was used to analyze the relationship between serum levels of CK18 M30 and M65 and the clinical characteristics.Furthermore,multiple linear stepwise regression analysis was used to analyze the independent correlation factors of CK18 M30 and M65.Results:(1)Compared to the healthy controls,the serum levels of CK18 M30 in CHB patients were significant increased(P < 0.001),the positive rate of CK18 M30 in the CHB patients was significant higher(?2 = 6.640,P < 0.05).But no markedly differences of serum levels of CK18 M30 were observed between HBV carriers and cirrhosis patients(all P > 0.05),as well as,the positive rate of CK18 M30 was not significant difference(?2 = 0.776,P = 0.378;?2 = 1.551,P > 0.05);Compared to the healthy controls,the serum levels of CK18 M65 in CHB patients and HBV carriers were significant increased(P all < 0.05),the positive rate of CK18 M65 was significant higher(?2 = 13.990,P <0.05;?2 = 5.405,P = 0.02).No markedly differences of serum levels of CK18 M65 were observed in cirrhosis patients(P > 0.05),as well as,the positive rate of CK18 M65 was not significant difference(?2 = 1.551,P > 0.05).(2)The levels of ALT,AST,r-GGT and ALP in HBV carriers were not significantly different from those in the control group(P all >0.05).The CK18 M65 levels and the positive rate of HBV carriers were higher than those of the control group.CK18 M65 was more sensitive in predicting early liver injury.(3)Compared with the HBV carriers,the serum levels of CK18 M30 in the CHB group increased significantly(P < 0.001),the positive rate also increased(?2 = 11.757,P=0.001),and there was no significant difference in the serum CK18 M65 levels(P = 0.102),But the positive rate increased(?2= 4.698,P = 0.03).(4)Serum levels of CK18 M30 was positively correlated with the serum levels of ALT,AST,GGT and lg HBV-DNA(r = 0.388,0.364,0.198,0.226,respectively,all P < 0.05),and CK18 M30 was negatively correlated with age(r =-0.194,P < 0.05).Serum levels of CK18 M65 was positively correlated with serum levels of ALT,AST,GGT,lg HBV-DNA,LN,PIIIP(r = 0.254?0.301?0.164?0.233?0.295?0.273,respectively,all P < 0.05).ALT and AST were independently correlated with the serum levels of CK18 M30 and M65.Conclusion:(1)Levels of serum CK18 M30 and M65 in different stages of HBV infection induced chronic liver diseases are different,and they have good consistency respectively with indicators commonly used clinically,which suggests M30 and M65 are likely to be used as noninvastive indexes for the diagnosis chronic liver diseases.(2)CK18 M65 is more sensitive than ALT and CK18 M30 in predicting the occurrence of early hepatitis.(3)CK18 M30 and M65 play a certain role in predicting the progression of HBV carriers to CHB. |
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