血清起始识别复合物蛋白1对HBV相关肝纤维化进程的诊断价值分析

Diagnostic value of serum origin recognition complex protein 1 in the progression of HBVrelated liver fibrosis

  • 摘要:
    目的 探讨人血清起始识别复合物蛋白1(ORC1)检测对乙型肝炎病毒(HBV)相关肝纤维化程度的诊断价值与意义。
    方法 选择2017年11月至2023年10月就诊于广西医科大学第一附属医院感染性疾病科并长期随访的269例HBV患者,采用瞬时弹性成像系统FibroScan检测患者的肝脏硬度值(LSM),按LSM值分为无肝纤维化组(n=69例)、轻度肝纤维化组(n=107例)、进展期肝纤维化组(n=43例)和肝硬化组(n=50例)。采用酶联免疫吸附法(ELISA)检测血清中ORC1水平。采用多重线性回归分析影响慢性HBV感染者血清ORC1水平的相关因素,有序多分类logistic回归分析影响肝纤维化程度的因素,受试者工作特征(ROC)曲线分析血清ORC1对肝硬化的预测价值。
    结果 进展期肝纤维化组血清ORC1水平高于无肝纤维化组,肝硬化组高于无肝纤维化组和轻度肝纤维化组(均P<0.05),无肝纤维化组与轻度肝纤维化组比较差异无统计学意义(P>0.05)。血清ORC1水平与LSM值呈正相关关系(P<0.05)。Logistic回归分析结果显示: 年龄增长,天冬氨酸转氨酶(AST)和血清ORC1水平升高,均为肝纤维化进展的危险因素(P<0.05);血清ORC1诊断肝硬化的ROC曲线下面积为0.644(P<0.05),截断值为1 000.46 ng/L,灵敏度、特异度、阳性预测值、阴性预测值及一致率分别为56.0%、76.3%、35.0%、88.4%、72.5%。
    结论 慢性HBV感染者血清ORC1水平与肝纤维化进程相关,其水平升高增加肝纤维化进展的风险性,有望成为动态监测和辅助诊断HBV相关肝纤维化进展及肝硬化的潜在血清学标志物之一。

     

    Abstract:
    Objective To explore the diagnostic value and significance of human serum origin recognition complex protein 1 (ORC1) in the degree of hepatitis B (HBV)-related liver fibrosis.
    Methods A total of 269 patients with HBV infection admitted to the Department of Infectious Diseases of the First Affiliated Hospital of Guangxi Medical University from November 2017 to October 2023 were enrolled in the long-term follow-up cohort. The transient elastography system FibroScan was used to detect liver stiffness value (LSM). According to the LSM value, they were divided into non-liver fibrosis group (n=69 cases), mild liver fibrosis group (n=107 cases), advanced liver fibrosis group (n=43 cases) and cirrhosis group (n=50 cases). The level of ORC1 in serum was detected by enzyme-linked immunosorbent assay (ELISA). Multiple linear regression was used to analyze the related factors affecting serum ORC1 level in chronic HBV patients, multi-classification logistic regression was used to analyze the factors affecting the degree of liver fibrosis, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum ORC1 in liver cirrhosis.
    Results The serum ORC1 level in the advanced liver fibrosis group was higher than that in the non-liver fibrosis group (P < 0.05). The level of serum ORC1 in the liver cirrhosis group was higher than that in the non-liver fibrosis group and mild liver fibrosis group (all P < 0.05). There was no significant difference between the non-liver fibrosis group and mild liver fibrosis group (P > 0.05). The level of serum ORC1 was positively correlated with LSM level (P < 0.05). The result of logistic regression analysis showed that the increasing age, increased aspartate aminotransferase (AST) and serum ORC1 levels were risk factors for the progression of liver fibrosis (P < 0 05). The area under the ROC curve of serum ORC1 in the diagnosis of liver cirrhosis was 0.644 (P < 0.05), the cutoff value was 1, 000.46 ng/L and the sensitivity, specificity, positive predictive value, negative predictive value, and consistency rate were 56.0%, 76.3%, 35.0%, 88.4%, and 72.5%, respectively.
    Conclusion The level of serum ORC1 in patients with chronic HBV infection is related to the progression of liver fibrosis, and its elevated level increases the risk of progression of liver fibrosis. It is expected to become one of the potential serological markers for monitoring dynamically and diagnosing helpfully of HBV-related progression of liver fibrosis and liver cirrhosis.

     

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