探讨YKL-40在肝硬变中的诊断价值及其与肝硬变患者肝功能和现有肝纤维化指标的相关性

摘要

目的:探讨血清YKL-40蛋白(壳多糖酶3样蛋白1)在肝硬变(LC)、原发性肝细胞癌(HCC)患者外周血中的水平及其在肝硬变诊断中的意义.方法:采用ELISA法共检测171例HCC患者、112例LC患者以及114例正常人血清中的YKL-40蛋白水平,并进一步分析其在肝硬变中的诊断价值及其与肝硬变患者肝功能和现有肝纤维化指标的相关性.结果:LC组血清YKL-40蛋白水平显著高于HCC组及正常对照组(P＜0.01);将肝硬变组和对照组作比较,ROC曲线分析血清YKL-40蛋白对肝硬变的诊断效能,曲线下面积(AUC)为0.934(95％置信区间为:0.904～0.964),YKL-40在cutoff值为92.25 ng/ml时敏感度为81.3％,特异度为90.4％;通过相关性分析发现,血清YKL-40蛋白水平与肝功能Child-Pugh分级和FIB--4指数呈正相关.结论:YKL--40在肝硬变和HCC患者中高表达,对肝硬变具有良好的诊断效力,能辅助诊断肝硬变并有助于判断肝硬变的严重程度.%Objective:To evaluate the serum level of YKL-40 in patients with hepatocellular carcinoma (HCC) and liver cirrhosis (LC),and its diagnosis values of LC.Methods:A total of 397 individuals enrolled in our study were divided into HCC group (n =171),LC group (n =112) and healthy control group (n =114).The serum level of YKL-40 were tested based on Enzyme-linked immunosorbent assay (ELISA) kit.Diagnostic value of YKL-40 and correlation with liver function and liver fibrosis indexes in patients with liver cirrhosis were analyzed.Results:The serum level of YKL-40 in LC group was statistically significant higher than that of HCC group and healthy control group (P ＜ 0.01).Compared with the healthy control group,ROC curve was used to analyze the diagnosis value of YKL-40 in LC,the area under the curve of LC group was 0.934 (95％ confidence interval:0.904-0.964).When the cutoff value of YKL-40 was 92.25 ng/ml,the sensitivity was 81.3％,and the specificity was 90.4％.The level of YKL-40 was positively correlated with Child-Pugh stage and the FIB-4 index.Conclusion:YKL-40 is highly expressed in patients with LC and HCC which might be a helpful marker in the diagnosis of LC and judgement the severity of LC.