血清GP73、CHI3L1表达与慢性乙型肝炎患者肝纤维化及病理变化程度的关系

doi:10.3969/j.issn.1006-5725.2024.11.020

Abstract

Abstract:

Objective Exploring the relationship between changes in serum Golgi apparatus transmembrane glycoprotein 73 （GP73） and chitosanase 3-like protein 1 （CHI3L1） levels and liver fibrosis and lesion severity in patients with hepatitis B （CHB）. Methods Using a case-control study， 80 patients diagnosed with CHB infection and developing liver fibrosis in the Infectious Disease Department of Changsha First Hospital from June 2020 to June 2023 were selected as the liver fibrosis group， while 120 patients diagnosed with CHB infection but not developing liver fibrosis in the Infectious Disease Department of our hospital were selected as the control group. The serum GP3， CHI3L1， liver function， and fibrosis indicators of the two groups of patients were compared， and the liver fibrosis group was divided into mild according to Scheuer system standards Perform stratified analysis on patients with significant liver fibrosis. Results The serum GP3 and CHI3L1 levels in the liver fibrosis group were significantly higher than those in the control group， with statistical significance （P < 0.05）； The ROC curves were plotted using serum GP3， CHI3L1， and GP3 + CHI3L1， respectively. The sensitivity for diagnosing liver fibrosis in CHB patients was 62.81%， 60.94%， and 96.33%， with specificity of 80.66%， 80.05%， and 75.30%. The AUC values under the curves were 0.792， 0.756， and 0.908， respectively； The levels of ALT， AST， HA， LN， PC III NP， C IV， and CG in the liver fibrosis group were higher than those in the control group， and the PLT measurement values were lower than those in the control group， with statistical significance （P < 0.05）； 49 patients with moderate to severe liver fibrosis （33 in S2 phase and 16 in S3 phase） and 31 patients with mild liver fibrosis （all in S1 phase） had significantly higher serum GP3 and CHI3L1 levels than mild patients， with statistical significance （P < 0.05）； The levels of DBIL， ALT， AST， HA， LN， PC III NP， C IV， and CG in patients with moderate to severe liver fibrosis were higher than those in the mild group， and the PLT measurement values were lower than those in the mild group， with statistical significance （P < 0.05）. Conclusion The serum GP3 and CHI3L1 levels in CHB patients with liver fibrosis are significantly elevated， and there is a certain correlation with the degree of liver fibrosis. The combination of these two indicators is beneficial for diagnosing liver fibrosis in CHB patients.

Key words: golgi apparatus transmembrane glycoprotein 73, chitosanase 3-like protein 1, chronic hepatitis b, liver fibrosis, scheuer system

CLC Number:

R575.1

Jin LU,Ming WEN,Qingrong TANG,Chunhua XU,Chunling ZHAN,Yizhou XU,Lihui. YANG. The relationship between the expression of serum GP3 and CHI3L1 and the degree of liver fibrosis and pathological changes in patients with hepatitis[J]. The Journal of Practical Medicine, 2024, 40(11): 1586-1591.

Figures/Tables 6

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References 25

1	CARGILL T， BARNES E. Therapeutic vaccination for treatment of chronic hepatitis B［J］. Clin Exp Immunol， 2021，205（2）：106-118. doi:10.1111/cei.13614 doi: 10.1111/cei.13614
2	YANG M， WEI L. Impact of NAFLD on the outcome of patients with chronic hepatitis B in Asia［J］. Liver Int， 2022，42（9）：1981-1990. doi:10.1111/liv.15252 doi: 10.1111/liv.15252
3	KOFFAS A， KUMAR M， GILL U S， et al. Chronic hepatitis B： the demise of the 'inactive carrier' phase［J］. Hepatol Int， 2021，15（2）：290-300. doi:10.1007/s12072-021-10137-2 doi: 10.1007/s12072-021-10137-2
4	FUNG S， CHOI H S J， GEHRING A，et al. Getting to HBV cure： The promising paths forward［J］. Hepatology， 2022，76（1）：233-250. doi:10.1002/hep.32314 doi: 10.1002/hep.32314
5	LIU L， ZHU J， YANG J， et al. GP73 facilitates hepatitis B virus replication by repressing the NF-κB signaling pathway［J］. J Med Virol， 2020，92（12）：3327-3335. doi:10.1002/jmv.25718 doi: 10.1002/jmv.25718
6	LI Y， LI C， ZHANG L，et al. Serum CHI3L1 as a diagnostic marker and risk factor for liver fibrosis in HBeAg-negative chronic hepatitis B［J］. Am J Transl Res， 2022，14（6）：4090-4096.
7	中华医学会肝病学分会，中华医学会感染病学分会. 慢性乙型肝炎防治指南［J］. 中华流行病学杂志， 2006，27（1）：79-88. doi:10.3760/j.issn:0254-6450.2006.01.021 doi: 10.3760/j.issn:0254-6450.2006.01.021
8	中华医学会肝病学分会，中华医学会消化病学分会，中华医学会感染病学分会. 肝纤维化诊断及治疗共识（2019年）［J］. 临床肝胆病杂志， 2019，35（10）：2163-2172. doi:10.3969/j.issn.1001-5256.2019.10.007 doi: 10.3969/j.issn.1001-5256.2019.10.007
9	ZHAO J， BIAN D， LIAO H，et al. Serum HBsAg and HBcrAg is associated with inflammation in HBeAg-positive chronic hepatitis B patients［J］. Front Cell Infect Microbiol， 2023，13（7）：1083912. doi:10.3389/fcimb.2023.1083912 doi: 10.3389/fcimb.2023.1083912
10	PHILLIPS S， JAGATIA R， CHOKSHI S. Novel therapeutic strategies for chronic hepatitis B［J］. Virulence， 2022，13（1）：1111-1132. doi:10.1080/21505594.2022.2093444 doi: 10.1080/21505594.2022.2093444
11	LIAO H， ZHANG H， SHAO J，et al. Nucleos（t）ide analogues altered quasispecies composition of hepatitis B virus （HBV）-resistant mutations in serum HBV DNA and serum HBV RNA［J］. J Med Virol， 2023，95（3）：e28612. doi:10.1002/jmv.28612 doi: 10.1002/jmv.28612
12	AKBAR S M F， YOSHIDA O， HIASA Y. Immune therapies against chronic hepatitis Bv［J］. J Gastroenterol， 2022，57（8）：517-528. doi:10.1007/s00535-022-01890-8 doi: 10.1007/s00535-022-01890-8
13	WANG Y， LIU Y， LIAO H，et al. Serum HBV DNA plus RNA reflecting cccDNA level before and during NAs treatment in HBeAg positive CHB patients［J］. Int J Med Sci， 2022，19（5）：858-866. doi:10.7150/ijms.71737 doi: 10.7150/ijms.71737
14	AIREWELE N E， SHIFFMAN M L. Chronic Hepatitis B Virus in Patients with Chronic Hepatitis C Virus［J］. Clin Liver Dis， 2021，25（4）：817-829. doi:10.1016/j.cld.2021.06.008 doi: 10.1016/j.cld.2021.06.008
15	SALAMA I I， SAMI S M， SALAMA S I，et al. Current and novel modalities for management of chronic hepatitis B infection［J］. World J Hepatol， 2023，15（5）：585-608. doi:10.4254/wjh.v15.i5.585 doi: 10.4254/wjh.v15.i5.585
16	亢倩，刘建湘，谭宁，等. 新型肝纤维化标志物评估慢性丙型肝炎患者肝硬化的诊断价值［J］. 中华肝脏病杂志， 2023，31（1）：56-64. doi:10.3760/cma.j.cn501113-20220329-00149 doi: 10.3760/cma.j.cn501113-20220329-00149
17	NISHIMURA N， DE BATTISTA D， MCGIVERN D R，et al. Chitinase 3-like 1 is a profibrogenic factor overexpressed in the aging liver and in patients with liver cirrhosis［J］. Proc Natl Acad Sci U S A， 2021，118（17）：e2019633118. doi:10.1073/pnas.2019633118 doi: 10.1073/pnas.2019633118
18	ZHU M， LU Y， LI W，et al. Erratum： Hepatitis B Virus X Protein Driven Alpha Fetoprotein Expression to Promote Malignant Behaviors of Normal Liver Cells and Hepatoma Cells： Erratum［J］. J Cancer， 2022，13（5）：1553-1554. doi:10.7150/jca.72443 doi: 10.7150/jca.72443
19	YE Q X， HUANG J F， XU Z J， et al. Short-term prognostic factors for hepatitis B virus-related acute-on-chronic liver failure［J］. World J Clin Cases， 2022，10（23）：8186-8195. doi:10.12998/wjcc.v10.i23.8186 doi: 10.12998/wjcc.v10.i23.8186
20	JIN X， FU B， WU Z J，et al. Serum chitinase-3-like protein 1 is a biomarker of liver fibrosis in patients with chronic hepatitis B in China［J］. Hepatobiliary Pancreat Dis Int， 2020，19（4）：384-389. doi:10.1016/j.hbpd.2020.05.009 doi: 10.1016/j.hbpd.2020.05.009
21	DAS A， KAMRUL-HASAN A， KABIR M R，et al. Evaluation of Chitinase 3-like 1 （CHI3L1） as a noninvasive biomarker of hepatic fibrosis in patients with Hepatitis B virus-related compensated chronic liver disease［J］. J Family Med Prim Care， 2021，10（4）：1694-1698. doi:10.4103/jfmpc.jfmpc_1922_20 doi: 10.4103/jfmpc.jfmpc_1922_20
22	BAO J， OUYANG Y， QIAO L，et al. Serum CHI3L1 as a Biomarker for Non-invasive Diagnosis of Liver Fibrosis［J］. Discov Med， 2022，33（168）：41-49.
23	王鹏飞，刘树红，钱相君，等. 血清高尔基体蛋白73对丙型肝炎肝硬化的诊断价值研究［J］. 中华肝脏病杂志，2022，30（8）：879-884. doi:10.3760/cma.j.cn501113-20200415-00186 doi: 10.3760/cma.j.cn501113-20200415-00186
24	JIANG Z， WANG S， JIN J，et al. The clinical significance of serum chitinase 3-like 1 in hepatitis B-related chronic liver diseases［J］. J Clin Lab Anal， 2020，34（5）：e23200. doi:10.1002/jcla.23200 doi: 10.1002/jcla.23200
25	童正喜，张克昌，郑奇. 血清高尔基体糖蛋白73、甲胎蛋白、CHI3L1在肝癌中的诊断价值及与患者预后的关系［J］. 热带医学杂志， 2020，20（6）：779-782+786.

组别	例数	年龄（岁）	BMI（kg/m²）	性别［例（%）］		吸烟［例（%）］	饮酒［例（%）］	高血压［例（%）］	糖尿病［例（%）］
组别	例数	年龄（岁）	BMI（kg/m²）	男	女	吸烟［例（%）］	饮酒［例（%）］	高血压［例（%）］	糖尿病［例（%）］
肝纤维化组	80	51.6 ± 8.5	22.60 ± 1.89	48（60.00）	32（40.00）	29（36.25）	23（28.75）	17（21.25）	9（11.25）
对照组	120	53.0 ± 9.4	23.05 ± 2.11	63（52.50）	57（47.50）	50（41.67）	43（35.83）	39（32.50）	19（15.83）
t/χ ² 值		-1.072	-1.540	1.093		0.589	1.089	3.013	0.837
P值		0.285	0.125	0.296		0.443	0.297	0.083	0.360

组别	例数	GP3	CHI3L1
肝纤维化组	80	146.8 ± 26.1	88.60 ± 15.13
对照组	120	78.5 ± 9.3	64.29 ± 11.07
t值		26.298	13.112
P值		0.000	0.000

指标	肝纤维化组（n = 80）	对照组（n = 120）	t值	P值
HBsAg阳性年限	12.6 ± 3.3	12.2 ± 3.1	0.871	0.385
WBC（×10⁹/L）	6.13 ± 1.50	5.88 ± 1.74	1.051	0.295
PLT（×10⁹/L）	170.9 ± 21.0	194.5 ± 23.6	-7.235	0.000
Hb（g/L）	139.6 ± 8.5	141.0 ± 11.3	-0.944	0.346
TBIL（μmol/L）	16.32 ± 3.40	15.85 ± 3.71	0.907	0.365
DBIL（μmol/L）	23.19 ± 5.10	22.05 ± 4.76	1.612	0.108
ALT（U/L）	28.63 ± 5.94	26.51 ± 6.40	2.361	0.019
AST（U/L）	24.75 ± 4.83	23.30 ± 4.22	2.186	0.030
γ-GT（U/L）	34.52 ± 8.13	36.18 ± 8.40	-1.387	0.167
HBV-DNA定量log值（copys/mL）	4.85 ± 1.20	5.20 ± 1.36	-1.867	0.063
INR	1.08 ± 0.16	1.06 ± 0.15	0.899	0.370
AFP（ng/mL）	19.63 ± 7.40	18.00 ± 5.84	1.735	0.084
HA（ng/mL）	89.63 ± 19.77	52.06 ± 8.74	18.321	0.000
LN（ng/mL）	32.66 ± 6.81	19.03 ± 4.41	17.186	0.000
PCⅢNP（ng/mL）	58.58 ± 14.03	30.04 ± 6.60	19.323	0.000
CⅣ（ng/mL）	35.84 ± 10.03	18.36 ± 4.00	17.169	0.000
CG（ng/mL）	6.96 ± 1.80	2.41 ± 0.84	24.059	0.000

组别	例数	GP3	CHI3L1
轻度	31	122.7 ± 24.8	75.40 ± 14.18
中重度	49	162.0 ± 21.5	96.95 ± 12.00
t值		-7.502	-7.289
P值		0.000	0.000

指标	轻度组（n = 31）	中重度组（n = 49）	t值	P值
HBsAg阳性年限(年)	12.2 ± 3.1	12.9 ± 2.9	-1.024	0.309
WBC（× 10⁹/L）	5.96 ± 1.43	6.24 ± 1.34	-0.887	0.378
PLT（× 10⁹/L）	178.4 ± 19.8	166.2 ± 19.5	2.710	0.008
Hb（g/L）	141.3 ± 8.2	138.5 ± 7.8	1.534	0.129
TBIL（μmol/L）	15.81 ± 3.15	16.64 ± 3.23	-1.130	0.262
DBIL（μmol/L）	21.64 ± 4.88	24.17 ± 4.89	-2.256	0.027
ALT（U/L）	26.08 ± 5.61	30.24 ± 5.50	-3.271	0.002
AST（U/L）	21.14 ± 3.95	24.67 ± 4.10	-3.805	0.000
γ-GT（U/L）	35.51 ± 7.86	33.89 ± 7.57	0.919	0.361
HBV-DNA定量log值（copy/mL）	4.58 ± 1.13	5.02 ± 1.18	-1.651	0.103
INR	1.11 ± 0.15	1.06 ± 0.14	1.514	0.134
AFP（ng/mL）	18.40 ± 7.15	20.41 ± 6.96	-1.245	0.217
HA（ng/mL）	76.44 ± 18.68	97.97 ± 18.80	-5.002	0.000
LN（ng/mL）	24.38 ± 6.55	37.90 ± 6.43	-9.097	0.000
PCⅢNP（ng/mL）	46.50 ± 13.37	66.22 ± 12.74	-6.617	0.000
CⅣ（ng/mL）	25.48 ± 9.86	42.39 ± 9.70	-7.548	0.000
CG（ng/mL）	5.17 ± 1.67	8.09 ± 1.43	-8.334	0.000

The relationship between the expression of serum GP3 and CHI3L1 and the degree of liver fibrosis and pathological changes in patients with hepatitis

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