The Value Of Golgi Protein 73 Expression In The Diagnosis Of Nonalcoholic Steatohepatitis And The Staging Of Hepatic Fibrosis

Objective In this study,the levels of Golgi protein 73(GP73)in serum and liver tissues of patients with non-alcoholic fatty liver disease(NAFLD)were measured,and Fibroscan was used to compare NAS values of liver tissue biopsy and liver fibrosis(HF)staging to explore the expression of GP73 Value in the diagnosis and staging of non-alcoholic steatohepatitis(NASH).Method A total of 91 patients with non-alcoholic fatty liver disease from December2016 to October 2019 were collected from the General Hospital of Ningxia Medical University,including 67 males and 24 females.According to liver tissue activity scores(NAS).The patients were divided into 46 patients with non-alcoholic steatohepatitis(NAFL)group and 45 patients with non-alcoholic steatohepatitis(NASH)group(NAS score> 4 and inflammatory manifestations of liver biopsy can diagnose NASH).At the same time,30 healthy subjects were selected as the control group;the serum GP73 level was detected by enzyme-linked immunoassay(ELISA);liver biopsy was used to check the pathological changes of liver histology of patients,and immunohistochemical method was used to detect the expression of GP73 in liver tissue;Observe the degree of liver tissue fibrosis(F)by conventional staining method,and liver stiffness was measured by Fibroscan.The obtained data was analyzed with the statistical software SPSS 22.0 in different clinical stages of serum and liver tissue GP73 levels,liver fibrosis was staged according to histology,and the serum and liver tissue GP73 levels were detected according to the staged grouping.The liver tissue GP73 levels and Correlation between fibrosis stage,liver tissue GP73 level and serum GP73 level,serum GP73 level and liver fibrosis stage correlation,and its combination with Fibroscan to analyze liver tissue and serum GP73 level Correlation of fibrosis stage,NFS fibrosis score and Fibroscan FS value of NAFLD patients were related to NASH(NAS> 4)and liver biopsy HF stage,respectively.Results 1.The BMI,age,serum ALT and PLT of the two groups were statistically significant(P<0.05),and there was no statistical difference in gender,AST,GGT,ALP,ALB,et al.(p>0.05);2.The serum GP73 in the control group,NAFL group and NASH group were(43.29 ± 5.94)ng/ml,(47.92 ± 9.83)ng/ml,and(62.17 ± 10.79)ng/ml.With the severity of NAFLD patients,serum GP73 also gradually increased(H=29.370,p=0.000),and the difference was statistically significant(P <0.05).The serum GP73 in NAFL group and NASH group was higher than that in normal control group,and the difference was statistically significant(P<0.05).The serum GP73 level in NASH group was higher than NAFL group,and the difference was statistically significant(P<0.05).3.Hepatic tissue staining results were classified into 53 cases of F0 stage(58.2%),29 cases of F1 stage(31.9%),and 9 cases of F?2stage(9.9%).Compare the average levels of serum GP73 in each group.F0 stage(50.20±11.26)ng/ml,F1 stage(61.38±10.71)ng/ml,and F?2 stage(62.34±13.16)ng/ml.The results showed that serum GP73 levels followed the fibrosis,The aggravation increased sequentially(H=17.954,p=0.000),and the difference was statistically significant(P>0.05).The NASH component was classified into 36 cases of F0-1 stage and 9 cases of F?2 stage.The results showed that stage F0-1(61.12±10.36)ng/ml,and stage F?2(62.34±13.16)ng/ml.The results showed that with the increase of NASH liver fibrosis,serum GP73 levels in NASH patients had little difference,no statistics differences(P>0.05).4.Immunohistochemistry of liver tissue showed that the expression of GP73 in liver tissue was negative,weakly positive,and medium-strongly positive in 23 cases(28.57%),54 cases(45.05%),and 14 cases(24.18%).Higher than the negative group(p<0.05),the serum GP73 levels in each group were negative(47.30±13.66)ng/ml,weakly positive(55.90±9.77)ngml,and moderate-strong positive(63.95±13.56)ng/ml,respectively.As the expression of GP73 in liver tissues gradually progressed from negative,weakly positive,and medium-strong positive,the corresponding serum GP73 levels also increased simultaneously,and the positive group was higher than the negative group(p <0.05).5.Spearson correlation analysis showed that serum was positively correlated with liver tissue GP73 levels(r=0.407,p=0.000).6.Serum and liver tissue GP73 levels in NAFLD patients were positively correlated with Fibroscan values(r=0.434,0.360,p<0.01 respectively).Serum and liver tissue GP73 in NAFLD patients were positively correlated with HF stage(F)(r=0.436,0.301,p<0.01 respectively).7.The area under the curve of GP73 and FS expression in NAFLD patients at NAS scores(NAS>4)were 0.830 and 0.852,respectively,and the sensitivity of serum GP73 and FS were(60.0%,95.6%),specificity was(97.8%,69.6%),p<0.05 respectively.The combined sensitivity of the two is 73.3%,and the specificity is 91.3%.The area under the ROC curve of the two combined is 0.857.8.The area under the curve of GP73 and FS expression in NAFLD patients at HF stage(F?2)was 0.672,The sensitivity of 0.864,serum GP73 and FS were(88.9%,100%),the specificity was(42.7%,67.1%),and the p<0.05 respectively.The combined sensitivity of the two is 66.7%,and the specificity is 78.0%.The area under the combined ROC curve is 0.737.9.NAFLD patients' NFS fibrosis score,Fibroscan and NAS scores(NAS>4)were positively correlated(r =0.555,0.609,p<0.01).10.The NFS fibrosis score,FS score of Fibroscan and liver HF staging(F?2)were positively correlated in NAFLD patients(r=0.212,0.376,p<0.05 respectively).Conclusions 1.Serum GP73 has a certain diagnostic effect on NASH.2.Serum GP73 combined with Fibroscan has certain specificity and sensitivity to NASH and liver fibrosis stages.3.The NFS fibrosis score and Fibroscan value have certain specificity and sensitivity to NASH and HF.Fibroscan has better auxiliary effect on NASH diagnosis.