Objective To build the mathematic models based on serum protein electrophoreses for diagnosis of hepatitis B associated fibrotic levels, and explore the methods of improving the efficacy of serum protein electrophoreses for diagnosis of fibrotic levels. Methods One hundred and eighty-nine patients with chronic hepatitis B were enrolled in this study. According to the pathological diagnosis, the fibrotic levels were classified in four stratifications, which were non-significant fibrosis ( pathological stage ＜ S2), significant fibrosis ( pathological stage ≥ S2 ), severe fibrosis ( pathological stage ≥ S3 ) and cirrhosis ( pathological stage = S4). The proportions of fractions of serum protein electrophoreses were measured by fully-automated Hydrasys and auxiliary reagents (Sebia Electrophoresis, France). The ratio models based on fractional function for diagnosis of fibrotic levels were built according to the correlation analysis of the proportions of fractions of serum protein electrophoreses to pathological stage of liver tissues. The top five large areas under ROC curve of the ratio models for diagnosis of different fibrotic levels were compared with the largest area under ROC curve of proportions of fractions of serum protein electrophoreses for diagnosis of different fibrotic levels to screen the optimal ratio model or fraction of serum protein electrophoreses. Results The proportions of fractions of largest areas under ROC curve of proportions of fractions of serum protein electrophoreses for diagnosis of significant fibrosis, severe fibrosis, cirrhosis were all the proportion of serum γ-globulin. There was no significant difference between the top five large areas under ROC curve of the ratio models for diagnosis of significant fibrosis, severe fibrosis, cirrhosis and the areas under ROC curve of the proportion of serum y-globulin for diagnosis of significant fibrosis, severe fibrosis, cirrhosis ( P ＞ 0. 05). Conclusion The efficacy of the ratio models based on serum protein electrophoreses for diagnosis of hepatitis B associated significant fibrosis, severe fibrosis, cirrhosis is not superior to that of the proportion of serum γ-globulin.%目的构建基于血清蛋白电泳诊断乙型肝炎相关肝纤维化程度的数学模型,探讨提升血清蛋白电泳诊断肝纤维化程度效能的方法.方法 189例慢性乙型肝炎患者入选本研究.根据病理学诊断,肝纤维化程度被分为非显著肝纤维化(病理学分期＜S2)、显著肝纤维化(病理学分期≥S2)、严重肝纤维化(病理学分期≥S3)和肝硬化(病理学分期=S4)4个层级.血清蛋白电泳采用法国Sebia公司生产的Hydrasys全自动电泳仪及其配套试剂检测.根据血清蛋白电泳各组分含量构成比与肝组织病理学分期之间的相关分析,构建血清蛋白电泳诊断乙型肝炎相关肝纤维化程度的比例模型.比较血清蛋白电泳组分含量构成比诊断不同肝纤维化程度的最大ROC曲线下面积和比例模型诊断不同肝纤维化程度的前5大ROC曲线下面积,筛选诊断肝纤维化程度的最佳血清蛋白电泳组分和比例模型.结果 诊断显著肝纤维化、严重肝纤维化、肝硬化的血清蛋白电泳各组分含量构成比中,ROC曲线下面积最大的组分含量构成比均为血清γ-球蛋白含量构成比.比例模型诊断显著肝纤维化、严重肝纤维化、肝硬化的前5大ROC曲线下面积与血清γ-球蛋白含量构成比诊断显著肝纤维化、严重肝纤维化、肝硬化的ROC曲线下面积之间均无显著性差异(P>0.05).结论 无论诊断显著肝纤维化、严重肝纤维化或肝硬化,基于SPE的比例模型的诊断价值均不优于γ-球蛋白含量构成比.
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