本文選題：甲胎蛋白　切入點(diǎn)：丙酮酸激酶M　出處：《中國(guó)臨床藥理學(xué)雜志》2017年12期 　論文類型：期刊論文

【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表達(dá)及其臨床意義。方法選擇89例慢性乙肝肝硬化患者作為肝硬化組,另選擇60例健康人群作為對(duì)照組。肝硬化組按照血清HBV-DNA檢測(cè)結(jié)果,再分為病毒復(fù)制組53例和非病毒復(fù)制組36例。抽取各組外周血5 mL,實(shí)時(shí)定量PCR法檢測(cè)肝硬化組與對(duì)照組血漿AFP、PKM2、Alb mRNA表達(dá)水平。熒光定量PCR檢測(cè)肝硬化患者血清HBV-DNA含量,分析血漿AFP、PKM2、Alb mRNA與HBV-DNA載量的相關(guān)性。根據(jù)AFP、PKM2、Alb mRNA相對(duì)表達(dá)量,繪制相應(yīng)ROC曲線。結(jié)果肝硬化組AFP mRNA相對(duì)表達(dá)量為13.6±2.1,PKM2 mRNA為6.4±0.5,Alb mRNA為15.1±2.5。對(duì)照組分別為7.6±0.7,1.4±0.2,7.2±0.5,肝硬化組AFP、PKM2、Alb mRNA表達(dá)量顯著高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。病毒復(fù)制組AFP mRNA相對(duì)表達(dá)量為15.3±4.2,PKM2 mRNA為7.6±0.7,Alb mRNA為18.2±4.5。非病毒復(fù)制組分別為11.1±2.4,4.6±0.3,10.5±1.7,病毒復(fù)制組AFP、PKM2、Alb mRNA表達(dá)量顯著高于非病毒復(fù)制組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。相關(guān)性分析顯示,AFP mRNA與HBV-DNA呈正相關(guān)(r=0.401,P0.05),PKM2 mRNA與HBV-DNA呈正相關(guān)(r=0.380,P0.05),Alb mRNA與HBV-DNA呈正相關(guān)(r=0.607,P0.001)。AFP mRNA ROC曲線下面積為0.885,最佳臨界值為8.7,對(duì)應(yīng)的敏感度為84.9%,特異度為84.3%;PKM2 mRNA ROC曲線下面積為0.879,最佳臨界值為3.4,對(duì)應(yīng)的敏感度為84.1%,特異度為81.7%;Alb mRNA ROC曲線下面積為0.921,最佳臨界值為9.5,對(duì)應(yīng)的敏感度為88.1%,特異度為96.8%。結(jié)論肝硬化患者血漿AFP、PKM2、Alb mRNA表達(dá)顯著增加,通過(guò)檢測(cè)外周血AFP、PKM2及Alb mRNA可以為肝硬化診斷提供參考。
[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.

【作者單位】： 武漢市東西湖區(qū)人民醫(yī)院檢驗(yàn)科;
【基金】：國(guó)家自然科學(xué)基金資助項(xiàng)目(30570070)
【分類號(hào)】：R440;R575.2

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