肝硬化患者外周血甲胎蛋白与丙酮酸激酶M2和白蛋白mRNA的表达及临床意义

发布时间：2018-03-14 14:28

本文选题：甲胎蛋白　切入点：丙酮酸激酶M　出处：《中国临床药理学杂志》2017年12期 　论文类型：期刊论文

【摘要】：目的研究慢性乙型病毒性肝炎(乙肝)肝硬化患者外周血甲胎蛋白(AFP)、丙酮酸激酶M2(PKM2)、白蛋白(Alb)mRNA表达及其临床意义。方法选择89例慢性乙肝肝硬化患者作为肝硬化组,另选择60例健康人群作为对照组。肝硬化组按照血清HBV-DNA检测结果,再分为病毒复制组53例和非病毒复制组36例。抽取各组外周血5 mL,实时定量PCR法检测肝硬化组与对照组血浆AFP、PKM2、Alb mRNA表达水平。荧光定量PCR检测肝硬化患者血清HBV-DNA含量,分析血浆AFP、PKM2、Alb mRNA与HBV-DNA载量的相关性。根据AFP、PKM2、Alb mRNA相对表达量,绘制相应ROC曲线。结果肝硬化组AFP mRNA相对表达量为13.6±2.1,PKM2 mRNA为6.4±0.5,Alb mRNA为15.1±2.5。对照组分别为7.6±0.7,1.4±0.2,7.2±0.5,肝硬化组AFP、PKM2、Alb mRNA表达量显著高于对照组,差异有统计学意义(P0.05)。病毒复制组AFP mRNA相对表达量为15.3±4.2,PKM2 mRNA为7.6±0.7,Alb mRNA为18.2±4.5。非病毒复制组分别为11.1±2.4,4.6±0.3,10.5±1.7,病毒复制组AFP、PKM2、Alb mRNA表达量显著高于非病毒复制组,差异有统计学意义(P0.05)。相关性分析显示,AFP mRNA与HBV-DNA呈正相关(r=0.401,P0.05),PKM2 mRNA与HBV-DNA呈正相关(r=0.380,P0.05),Alb mRNA与HBV-DNA呈正相关(r=0.607,P0.001)。AFP mRNA ROC曲线下面积为0.885,最佳临界值为8.7,对应的敏感度为84.9%,特异度为84.3%;PKM2 mRNA ROC曲线下面积为0.879,最佳临界值为3.4,对应的敏感度为84.1%,特异度为81.7%;Alb mRNA ROC曲线下面积为0.921,最佳临界值为9.5,对应的敏感度为88.1%,特异度为96.8%。结论肝硬化患者血浆AFP、PKM2、Alb mRNA表达显著增加,通过检测外周血AFP、PKM2及Alb mRNA可以为肝硬化诊断提供参考。
[Abstract]:Objective to study the chronic hepatitis B virus (HBV) in liver cirrhosis patients with peripheral alpha fetoprotein (AFP), pyruvate kinase M2 (PKM2), albumin (Alb) mRNA expression and its clinical significance. Methods 89 cases of chronic hepatitis B patients with cirrhosis as cirrhosis group, another 60 healthy people as control group. The liver cirrhosis group according to serum the results of HBV-DNA detection, virus replication was divided into group 53 cases and non viral replication group 36 cases. 5 mL blood samples were peripheral, detection of liver cirrhosis group and control group by real-time PCR plasma AFP, PKM2, Alb and mRNA. The expression level of fluorescence quantitative PCR detection of serum HBV-DNA levels in patients with liver cirrhosis, analysis of plasma AFP, PKM2. The correlation between Alb mRNA and HBV-DNA load. According to AFP, PKM2, relative expression of Alb mRNA ROC, drawing the corresponding curves. The relative expression of AFP mRNA in liver cirrhosis group was 13.6 + 2.1, 6.4 + PKM2 mRNA 0.5, Alb mRNA 15.1 + 2.5. control Group were 7.6 + 0.7,1.4 + 0.2,7.2 + 0.5, AFP, PKM2, Alb in liver cirrhosis group, the expression of mRNA was significantly higher than the control group, the difference was statistically significant (P0.05). The virus replication group AFP mRNA relative expression was 15.3 + 4.2, 7.6 + PKM2 mRNA 0.7, Alb mRNA 18.2 + 4.5. for non viral replication group were 11.1 + 2.4,4.6 + 0.3,10.5 + 1.7, virus replication groups AFP, PKM2, Alb mRNA expression was significantly higher than that of non viral replication group, the difference was statistically significant (P0.05). Correlation analysis showed that AFP mRNA was positively correlated with HBV-DNA (r=0.401, P0.05), PKM2 mRNA was positively correlated with HBV-DNA (r=0.380, P0.05). Alb mRNA was positively correlated with HBV-DNA (r=0.607, P0.001).AFP mRNA ROC area under the curve is 0.885, the optimal cut-off value was 8.7, the sensitivity was 84.9%, specificity was 84.3%; the area under the ROC curve of PKM2 mRNA is 0.879, the optimal cut-off value was 3.4, the sensitivity was 84.1%, specificity was 81. The area under.7%, Alb mRNA ROC curve is 0.921, the best critical value is 9.5, the corresponding sensitivity is 88.1%, the specificity is 96.8%.. Conclusion the expression of AFP, PKM2 and Alb mRNA in liver cirrhosis patients is significantly increased. By detecting peripheral blood AFP, PKM2 and mRNA, we can provide reference for diagnosis of liver cirrhosis.

【作者单位】：武汉市东西湖区人民医院检验科;
【基金】：国家自然科学基金资助项目(30570070)
【分类号】：R440;R575.2

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