慢性丙型肝炎患者血清Pygo2水平对肝纤维化程度的评估价值探讨*

目的 探讨血清人尾肢同源蛋白（Pygo）水平诊断慢性丙型肝炎（CHC）患者肝纤维化的价值。方法 本研究共入组90例慢性丙型肝炎患者，根据肝活检病理学检查肝纤维化程度，分为F0～F4组，采用ELISA法检测血清Pygo2水平。以肝活检病理检查结果为金标准绘制受试者工作特征曲线，并计算曲线下面积评估慢性丙型肝炎患者血清Pygo2水平对肝纤维化的诊断价值。结果 在90例CHC患者中，经肝组织病理学检查，诊断F0、F1、F2、F3和F4分别为6例（6.7%）、13例（14.4%）、26例（28.9%）、35例（38.9%）和10（11.1%）；F2组血清Pygo水平显著高于F1组（70.1±19.8）ng/ml对（55.9±20.4）ng/ml，P＜0.05]，F3组（100.1±24.6）ng/ml]显著高于F2组（P＜0.001），F4组（145.6±45.7）ng/ml]显著高于F3组（P＜0.01）；血清Pygo2水平与肝纤维化分期呈显著正相关（r=0.704，P＜0.01）；分别以血清Pygo2水平≥69.1 ng/mL、≥83.9 ng/mL和以≥109.60ng/mL为诊断显著肝纤维化、严重肝纤维化和肝硬化的截断点，其AUC值分别为0.8824、0.9004和0.8834，95%可信区间分别为0.806～0.959、0.836～0.964和0.768～0.999。结论 在慢性丙型肝炎患者的各项检查指标中，血清Pygo2水平作为一种简单、有效的血清学指标，可有效评估患者肝纤维化程度。

Serum Pygo2 levels as an indicator of liver fibrosis in patients with chronic hepatitis C

Objective To explore the reliability of serum people end limb homologous protein 2 （Pygo2） levels in diagnosis of liver fibrosis in patients with chronic hepatitis C（CHC）.Methods 90 patients with CHC were enrolled in this study， and they were divided into F0，F1，F2，F3 and F4 hepatic fibrosis according to liver fibrosis scores. Serum Pygo2 levels were tested by enzyme-linked immunosorbent assay，and the correlation between serum Pygo2 levels and liver fibrosis staging was performed. With liver biopsy as the gold standard of diagnosis，the ROC curves were delineated and the area under the curves（AUC） was calculated to evaluate the diagnostic efficacy for liver fibrosis.Results Out of 90 patients with CHC，the histopathological examination found F0 in 6 cases （6.7%），F1 in 13 （14.4%），F2 in 26（28.9%），F3 in 35 （38.9%） and F4 in 10（11.1%）；Serum Pygo2 levels in F2 group was higher than that in F1 （70.1±19.8） ng/ml vs. （55.9±20.4） ng/ml，P＜0.05]，serum Pygo2 levels （100.1±24.6） ng/ml] in F3 was significantly higher than that in F2（P＜0.001），and serum Pygo2 levels in F4 （145.6±45.7） ng/ml] was much higher than in F3 （P＜0.01）；There were a statistically positive correlation between serum Pygo2 levels and hepatic fibrosis staging（r=0.704，P＜0.01）；assuming serum Pygo2 levels ≥69.1 ng/mL，≥83.9 ng/mL and ≥109.60ng/mL as the cut-off-value for diagnosis of obvious（F≥2） and severe liver fibrosis （F≥3） or liver cirrosis （F=4），the AUC of ROC curves were 0.8824 （95% CI:0.806～0.959），0.9004 （95% CI:0.836～0.964） and 0.8834 （95% CI:0.768～0.999），respectively.Conclusion Serum Pygo2 level could be used to diagnose liver fibrosis in patients with CHC， which warrants further study.