【摘要】 目的探讨甲胎蛋白异质体L3(AFP-L3)、高尔基体糖蛋白73(GP-73)、AFP等标志物和IL-4、IL-10、IL-17等细胞因子在HBV患者外周血高表达的临床意义。方法 30名健康体检者(健康对照组)、34例慢性乙型肝炎患者(CHB组)、50例HBV感染相关肝细胞癌患者(HCC组)纳入研究队列,ELISA方法检测外周血两类指标的表达水平,Mann-Whitney U检验分析各组指标的整体差异,Spearman方法分析标志物和细胞因子表达水平的相关性。结果 HCC组患者外周血标志物表达水平升高。CHB组AFP表达水平较健康对照组显著升高(Z=-6.86,P=0.000);HCC组AFP-L3、GP-73、AFP水平分别较健康对照组(Z=-6.88,Z=-6.30,Z=-7.40;P=0.000)和CHB组显著升高(Z=-6.67,P=0.000;Z=-2.38,P=0.017;Z=-6.48,P=0.000)。CHB组和HCC组患者外周血细胞因子表达水平升高。CHB组IL-4表达水平较健康对照组变化明显(Z=-6.09,P=0.000),HCC组IL-4、IL-10、IL-17水平较健康对照组显著上升(Z=-6.36,P=0.000;Z=-3.09,P=0.002;Z=-4.42,P=0.000),与CHB组IL-10、IL-17水平比较差异有统计学意义(Z=-3.80,Z=-3.90;P=0.000)。CHB组和HCC组标志物与细胞因子的表达水平之间存在显著相关性。健康对照组仅AFP-L3与IL-10的表达水平之间存在正相关性(P=0.032),CHB组AFP-L3和AFP表达水平分别与细胞因子存在正相关性且差异有统计学意义(P均<0.05),GP-73与IL-17水平存在正相关性(P=0.031);HCC组AFP-L3和GP-73的表达水平分别与IL-4、IL-10、IL-17显著正相关(P=0.000)。结论 HBV感染者外周血AFP-L3、GP-73等标志物和细胞因子表达水平依赖于临床病程分期而明显升高,且两类标志物相关性高,可在临床诊疗HBV感染相关CHB和HCC患者中发挥一定的作用。更多还原

【Abstract】 Objective To investigate the clinical significance of high expression markers(AFP-L3, GP-73, AFP) and cytokines(IL-4, IL-10, IL-17) in HBV patients. Methods 30 healthy people(healthy control group), 34 cases chronic hepatitis B patients(CHB group) and 50 cases HBV infection-related hepatocellular carcinoma patients(HCC group) were included in the cohort. Levels of markers were detected by ELISA, overall difference of each group was analyzed by Mann-Whitney U test, Spearman method was used to analyze the correlation. Results The expressions of markers were higher in HCC group. Level of AFP in CHB group was significantly higher than that in healthy control group(Z=-6.86, P=0.000), levels of AFP-L3, GP-73 and AFP in HCC group were significantly higher than those in healthy control group(Z=-6.88, Z=-6.30, Z=-7.40, P=0.000) and CHB group(Z=-6.67, P=0.000; Z=-2.38, P=0.017; Z=-6.48, P=0.000). The expressions of cytokines were higher in CHB group and HCC group. Levels of IL-4 in CHB group were significantly different than those in healthy control group(Z=-6.09, P=0.000), the levels of IL-4, IL-10 and IL-17 in HCC group were significantly higher than those in healthy control group(Z=-6.36, P=0.000; Z=-3.09, P=0.002; Z=-4.42, P=0.000), and there was a significant difference between levels of IL-10 and IL-17 in CHB group(Z=-3.80, Z=-3.90; P=0.000). There was a significant correlation between the expression of markers and cytokines in CHB group and HCC group. There was a significant positive correlation between AFP-L3 and IL-10 in healthy control group(P=0.032), levels of AFP-L3 and AFP were significantly positive correlated with cytokines in CHB group(P<0.05), and also there was a significant positive correlation between the expression of GP-73 and IL-17(P=0.031). The expressions of AFP-L3 and GP-73 were significantly positive correlated with IL-4, IL-10 and IL-17 in HCC group, respectively(P=0.000). Conclusion The expressions of AFP-L3, GP73 and cytokines in peripheral blood of HBV patients are significantly increased depending on the clinical stage, which can play a practical value in clinical diagnosis of HBV infection-related CHB and HCC.更多还原