【摘 要】
：
目的 探讨磷脂酰肌醇蛋白多糖3(GPC3)在胆道闭锁(BA)患儿中表达水平及其与肝纤维化的关系.方法 收集BA患儿41例(BA组)、胆总管囊肿(CC)患儿9例(CC组)、肝功能正常无其他肝胆疾病的体检健康婴儿12例(NC组).用酶联免疫吸附试验(ELISA)检测3组血清GPC3水平,使用受试者工作特征(ROC)曲线评估GPC3对BA的辅助诊断价值.留取BA组和CC组肝组织样本,通过免疫组织化学染色和实时荧光定量PCR检测GPC3在患儿肝组织中表达水平,分析BA患儿GPC3与肝纤维化分级的关系.结果(1)B
【机 构】
：
天津医科大学研究生院 300070;天津市儿童医院普外科;天津市儿童医院普外科;天津市儿童医院儿科研究所;天津市儿童医院检验科;天津市儿童医院病理科
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目的 探讨磷脂酰肌醇蛋白多糖3(GPC3)在胆道闭锁(BA)患儿中表达水平及其与肝纤维化的关系.方法 收集BA患儿41例(BA组)、胆总管囊肿(CC)患儿9例(CC组)、肝功能正常无其他肝胆疾病的体检健康婴儿12例(NC组).用酶联免疫吸附试验(ELISA)检测3组血清GPC3水平,使用受试者工作特征(ROC)曲线评估GPC3对BA的辅助诊断价值.留取BA组和CC组肝组织样本,通过免疫组织化学染色和实时荧光定量PCR检测GPC3在患儿肝组织中表达水平,分析BA患儿GPC3与肝纤维化分级的关系.结果(1)BA组GPC3水平高于CC组和NC组(χ2=24.170,P30 d的患儿(20例)血清GPC3水平差异无统计学意义,但均高于CC组和NC组(χ2=24.210,P<0.01).BA组内Ⅰ～Ⅱ级与Ⅲ～Ⅳ级患儿GPC3水平差异无统计学意义,但均高于CC组和NC组(χ2=24.390,P<0.01).GPC3诊断BA的ROC曲线下面积为0.878(95％CI:0.792～0.965,P<0.01),敏感度为82.93％,特异度为80.95％,最佳临界值为0.639μg/L.(2)肝组织免疫组织化学检测结果显示,BA组肝组织中GPC3表达较CC组明显升高(Z=3.565,P<0.01);肝组织中GPC3的含量与肝纤维化分级呈正相关(rs=0.619,P<0.01).BA组GPC3 mRNA表达较CC组上调(Z=7.361,P<0.05).结论 血清GPC3对BA的诊断及鉴别诊断有一定临床价值;BA肝组织中GPC3表达上调,其表达量与胆道闭锁的肝纤维化分级呈正相关.
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