Chinese Hepatolgy ›› 2019, Vol. 24 ›› Issue (2): 133-137.

• Original Articles • Previous Articles     Next Articles

The efficiency of serum GP73 combined with AST for diagnosing liver inflammation in patients with chronic hepatitis B

WANG chun-yan1, HAN Ping2, JI Dong1, Ma Li-jun3, WANG jing-jing1, SHAO Qing1, CHEN Guo-feng1   

  1. 1. The Second Liver Cirrhosis Diagnosis and Treatment Center, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China;
    2. Cancer Radiotherapy Center, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 10039, China;
    3. Department of infectious diseases,People's Hospital of Ding Xi, Gansu 743000, China
  • Received:2018-07-16 Published:2020-04-10
  • Contact: CHEN Guo-feng, Email: guofengchen302@163.com; HAN Ping, Email: hanp1966@sina.com

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Abstract: Objective To investigate the correlation between serum Golgi protein 73 (GP73) and liver inflammation in patients with chronic hepatitis B (CHB), and to assess the diagnostic accuracy of the noninvasive model based on GP73 and aspartate aminotransferase (AST) for significant liver inflammation (inflammation grade ≥G2).Methods A total of 422 treatment-nave CHB patients were divided into group 1 [whose alanine aminotransferase (ALT) ＜ 2×upper limit of normal (ULN), n=220] and group 2 (whose ALT ≥ 2×ULN, n=200). GP73, AST, ALT and other biochemical indices were detected in all patients. Patients in group 1 were with liver biopsy (LB), and the correlation between GP73 and pathological inflammation of liver tissue was analyzed. The noninvasive diagnostic model was established using binary logistic regression analysis and the diagnostic efficacy of significant hepatic inflammation (≥G2) was evaluated using receiver-operating characteristic (ROC) curve.Results GP73 level of group 1 (median, 50.68 ng/mL) was significantly lower than that of group 2 (median, 110.6 ng/mL)(P<0.001). In group 1, 57 cases (25.7%) and 110 cases (49.5%) showed significant hepatic inflammation (≥G2) and fibrosis (fibrosis stage ≥S2), respectively. The GP73 level of the significant hepatic inflammatory group (≥G2) was higher than that of invisible hepatic inflammatory group (G0-G1) (P<0.001), which showed positive correlation with inflammation grades in group 1 (correlation coefficient=0.405, P<0.001). The efficiency of noninvasive diagnosis model based on GP73 combined with AST in the diagnosis of significant liver inflammation (≥G2) was better than separate application of GP73, ALT or AST. The area under the ROC curve of this model was 0.836, and its sensitivity and specificity were 75.44% and 80.61% (P<0.01), respectively. When the cut-off values were ≤2.88 and ≥ 4.2, 80.6% (175/222) treatment-nave CHB patients could use this noninvasive diagnosis model without resorting to LB.Conclusion Serum GP73 level is closely correlated with liver inflammation in CHB patients. The noninvasive diagnostic model of GP73 combined with AST can accurately predict significant liver inflammation. It can be used as an alternative for LB to determine whether patients with ALT less than 2ULN need antiviral therapy or not.

Key words: Chronic hepatitis B, Golgi protein 73, Significant liver inflammation, Noninvasive model