CAJ | 학술논문

目的：探讨肝硬度检测（ LSM）联合血清超敏C反应蛋白（ hs?CRP）检测在诊断乙肝肝硬化并发原发性肝癌中的价值。方法将156例未经治疗的乙肝肝硬化患者分为原发性肝癌组和肝硬化组，对两组患者的LSM值和血清hs?CRP水平进行对比分析。结果原发性肝癌组患者的LSM值为（39．72±29．05）kPa，显著高于肝硬化组[（27．81±18．46） kPa]和健康对照组[（4．25±0．74） kPa]，差异有统计学意义（P＜0．01）。原发性肝癌组患者的中位hs?CRP水平为5．81 mg／L，显著高于肝硬化组（1．78 mg／L）和健康对照组（0．38 mg／L），差异有统计学意义（P＜0．01）。 LSM值分级越高，乙肝肝硬化并发原发性肝癌患者的hs?CRP阳性率越高。在LSM值≥27．6 kPa患者中，原发性肝癌组的hs?CRP阳性率为64．2％，肝硬化组的 hs?CRP 阳性率为38．0％，差异有统计学意义（ P ＜0．01）。67例乙肝肝硬化并发原发性肝癌患者中，AFP阳性患者的LSM值和中位hs?CRP水平分别为（48．95±28．59）kPa和4．91 mg／L，甲胎蛋白（AFP）阴性患者的 LSM 值和中位 hs?CRP水平分别为（28．64±26．83）kPa和4．16 mg／L，AFP阳性患者的LSM值和中位hs?CRP水平均高于AFP阴性患者，但差异无统计学意义（P＞0．05）。结论应用LSM值分级联合血清hs?CRP检测具有潜在的诊断乙肝肝硬化并发原发性肝癌的价值。
목적：탐토간경도검측（ LSM）연합혈청초민C반응단백（ hs?CRP）검측재진단을간간경화병발원발성간암중적개치。방법장156례미경치료적을간간경화환자분위원발성간암조화간경화조，대량조환자적LSM치화혈청hs?CRP수평진행대비분석。결과원발성간암조환자적LSM치위（39．72±29．05）kPa，현저고우간경화조[（27．81±18．46） kPa]화건강대조조[（4．25±0．74） kPa]，차이유통계학의의（P＜0．01）。원발성간암조환자적중위hs?CRP수평위5．81 mg／L，현저고우간경화조（1．78 mg／L）화건강대조조（0．38 mg／L），차이유통계학의의（P＜0．01）。 LSM치분급월고，을간간경화병발원발성간암환자적hs?CRP양성솔월고。재LSM치≥27．6 kPa환자중，원발성간암조적hs?CRP양성솔위64．2％，간경화조적 hs?CRP 양성솔위38．0％，차이유통계학의의（ P ＜0．01）。67례을간간경화병발원발성간암환자중，AFP양성환자적LSM치화중위hs?CRP수평분별위（48．95±28．59）kPa화4．91 mg／L，갑태단백（AFP）음성환자적 LSM 치화중위 hs?CRP수평분별위（28．64±26．83）kPa화4．16 mg／L，AFP양성환자적LSM치화중위hs?CRP수평균고우AFP음성환자，단차이무통계학의의（P＞0．05）。결론응용LSM치분급연합혈청hs?CRP검측구유잠재적진단을간간경화병발원발성간암적개치。
Objective The aim of this study was to explore the diagnostic value of liver stiffness measurement combined with serum high?sensitivity C?reactive protein detection in HBV?related cirrhosis patients complicated with primary liver cancer. Methods A total of 156 previously untreated chronic hepatitis B?related cirrhosis patients and 50 healthy subjects were included in this study. The 156 patients were divided into two groups: those with primary liver cancer ( 67 cases ) and without liver cancer ( 89 cases) . The 50 healthy subjects were considered as normal control group. Liver stiffness measurement ( LSM) was conducted and serum high?sensitivity C?reactive protein ( CRP) level was assayed in all the 156 patients and 50 normal individuals, and their measurement values were statistically compared and analyzed. Results The LSM value was (39. 72 ± 29. 05)kPa in the liver cancer patients, significantly higher than the (27. 81 ± 18. 46 ) kPa in the cirrhosis alone patients and ( 4. 25 ± 0. 74 ) kPa in the healthy controls (P<0. 01 for both). Serum hs?CRP levels in the liver cancer patients was 5. 81mg/L, significantly higher than 1. 78 mg/L in the cirrhosis alone patients and 0. 38mg/L in healthy controls, (P<0. 01 for both). The higher the grade of LSM values was, the positive rate of CRP was higher in the cirrhosis patients complicated with primary liver cancer. In patients with LSM values≥27. 6 kPa, the serum CRP positive rate was 64. 2%in patients with primary liver cancer, significantly higher than the 38. 0% in patients with cirrhosis alone (P<0. 01). In the 67 HBV?related cirrhosis patients complicated primary liver cancer, the LSM value and serum hs?CRP level in AFP?positive patients were ( 48. 95 ± 28. 59 ) kPa and 4. 91 mg/L, respectively, higher than those in the AFP?negative patients (28. 64 ± 26. 83) kPa and 4. 16 mg/L, but with a non?significant difference (P >0. 05). Conclusion Liver stiffness measurement combined with serum high? sensitivity C?reactive protein detection may have potential diagnostic implications as a marker of primary liver cancer occurrence in patients with HBV?related cirrhosis.