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目的探讨诱骗受体3(Dc R3)在乙型肝炎肝纤维化患者中的表达及临床意义。方法收集临床确诊为慢性乙型肝炎患者血清100例,均进行肝组织学病理活检,对照组为同期体检的健康者50名。根据病理纤维化评分,试验分为三组:NC(健康对照组)、S0(未有纤维化乙型肝炎患者组)和S1~4(伴有纤维化乙型肝炎患者组)。Dc R3、透明质酸酶(HA)、Ⅲ型前胶原蛋白(PCⅢ)、Ⅳ型胶原(Ⅳ-C)和层粘连蛋白(LN)的检测采用酶联免疫吸附实验(ELISA)。SPSS统计学分析不同组血清指标的表达差异,绘制受试者工作曲线(ROC),评估Dc R3对乙型肝炎肝纤维化的诊断能力。采用Ocomine生物信息学分析人类肝细胞癌DNA芯片数据库中Dc R3 DNA拷贝数与正常肝组织间的差异。结果 Dc R3在肝纤维化组(S1~4)明显升高(P<0.01),并且与肝纤维化四项指标具有显著相关性,Dc R3与HA:r=0.51,P<0.000 1;Dc R3与Ⅳ-C:r=0.34,P=0.001 3;Dc R3与PCⅢ:r=0.49,P<0.000 1;Dc R3与LN:r=0.40,P<0.000 1。Dc R3对乙型肝炎肝纤维化的诊断敏感度76.90%,特异度87.80%,曲线下面积分别是0.770,cut-off值168.67 ng/ml。Oncomine生物信息学分析发现肝细胞癌患者中Dc R3 DNA拷贝数明显高于正常肝组织。结论 Dc R3在乙型肝炎肝纤维化中明显升高,与常规的肝纤维化四项相比,Dc R3和Ⅳ-C具有较好的诊断能力,Dc R3在肝纤维化-肝硬化-肝癌的发展过程中可能发挥了重要的作用。
Objective To investigate the expression and clinical significance of decoy receptor 3 (Dc R3) in patients with hepatitis B liver fibrosis. Methods 100 cases of clinically diagnosed patients with chronic hepatitis B were collected for pathological biopsy of liver histology. The control group consisted of 50 healthy people who were examined at the same period. According to the pathological fibrosis score, the experiment was divided into three groups: NC (healthy control group), S0 (patients without fibrosis hepatitis B group) and S1-4 (patients with fibrosis hepatitis B group). Enzyme-linked immunosorbent assay (ELISA) was used to detect Dc R3, HA, PCⅢ, Ⅳ-C and LN. SPSS statistical analysis of different groups of serum indicators of differences in the expression of the working curve of the subjects (ROC), assessment of Dc R3 on the diagnosis of hepatitis B liver fibrosis. Ocomine bioinformatics was used to analyze the difference between Dc R3 DNA copy number and normal liver tissue in human hepatocellular carcinoma DNA microarray database. Results Dc R3 was significantly increased in S1 ~ 4 group (P <0.01), and significantly correlated with the four indexes of liver fibrosis. Dc R3 and HA: r = 0.51, P <0.0001; R3 and IV-C: r = 0.34, P = 0.001 3; Dc R3 and PCIII: r = 0.49, P <0.0001; Dc R3 and LN: r = 0.40, P <0.0001. Dc R3 had a sensitivity of 76.90% and a specificity of 87.80% for diagnosing hepatitis B liver fibrosis, with an area under the curve of 0.770 and a cut-off of 168.67 ng / ml, respectively. Oncomine bioinformatics analysis found that patients with hepatocellular carcinoma Dc R3 DNA copy number was significantly higher than normal liver tissue. Conclusions Dc R3 is significantly increased in hepatitis B liver fibrosis. Dc R3 and Ⅳ-C have better diagnostic ability than those of conventional hepatic fibrosis. Dc R3 is more effective in diagnosing liver fibrosis-liver cirrhosis-liver cancer The development process may play an important role.