Clinical significance of serum CER, HA and FT3 in diagnosis of liver fibrosis in chronic hepatitis B patients / 解放军医学杂志

ABSTRACT

Objective To investigate the clinical significance of serum ceruloplasmin (CER), hyaluronic acid (HA) and free thyroxine 3 (FT3) in detecting liver fibrosis in patients with chronic hepatitis B (CHB). Methods One hundred and thirty-six cases of CHB patients, 44 cases of post-CHB cirrhosis patients, 20 cases with HBsAg-positive hepatocellular carcinoma (HCC), and 50 healthy controls were randomly selected from July 2014 to January 2018. Serum CER was detected by immune scattering turbidimetry, and direct chemiluminescence method was used for the detection of HA and FT3, one-way ANOVA analysis or rank sum test was used to compare the levels of serum CER, HA, FT3 and other related indexes between each group and the control group. Analysis of the correlation between CER, HA, FT3 and diagnosis model of liver fibrosis was performed and its results were analyzed using the receiver operating characteristic (ROC) curves. Results (1) The level of serum CER in severe CHB and decompensated liver cirrhosis group was significantly lower than that in control group (P<0.05). The concentration of HA in severe CHB and liver sclerosis groups was significantly higher than that in control group, and the difference was statistically significant (P<0.05). And the concentration of FT3 in cirrhotic group and HCC group was significantly different from that in control group (P<0.05). (2) CER was negatively correlated with APRI (r=-0.202, P=0.004) and FIB-4 (r=-0.200, P=0.006), HA was positively correlated with APRI (r=0.491, P<0.000) and FIB-4 (r=0.514, P<0.000), and FT3 was positively correlated with APRI (r=-0.246, P<0.001) and FIB-4 (r= 0.361, P<0.000). (3) The AUC (area under the curve) of FT3, HA and CER for the diagnosis of cirrhosis were 0.831, 0.826 and 0.668, respectively. In order from high to low, the diagnostic efficacy of the groups was CER+HA+FT3, HA+FT3, CER+HA and CER+FT3. Conclusion The levels of serum CER, HA and FT3 in patients with CHB are correlated with the degree of liver fibrosis, and has an important reference value for diagnosis of post-CHB cirrhosis.