Complement 5a is an indicator of significant fibrosis and earlier cirrhosis in patients chronically infected with hepatitis B virus.
Complement 5a is an indicator of significant fibrosis and earlier cirrhosis in patients chronically infected with hepatitis B virus.
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DOI：
10.1007/s15010-016-0942-7
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发表时间：
2017-02
期刊：
影响因子：
7.5
通讯作者：
China HepB-Related Fibrosis Assessment Research Group
中科院分区：
文献类型：
--
作者：
Deng Y;Zhao H;Zhou J;Yan L;Wang G;China HepB-Related Fibrosis Assessment Research Group
目的探讨血清补体5a(C5a)浓度与慢性乙型肝炎病毒(HBV)感染者肝纤维化和肝硬变的关系。508例慢性乙肝患者接受肝活检。采用Luminex筛查系统测定血清C5a浓度。获得了Ishak组织学系统。C5a水平与肝纤维化分期呈负相关，重度肝纤维化和肝硬变患者C5a水平显著下降(P<0.001)。多因素分析显示C5a、AST、层粘连蛋白、Co-IV、血小板计数、白蛋白、乙肝表面抗原与肝纤维化独立相关。基于上述标记物，我们创建了两个评分，Fib模型表示显著纤维化，Cirrh模型表示早期肝硬变。与已有的APRI、FIB-4和Forns‘s index相比，FIB模型对显著纤维化的鉴别能力更好，AUROC为0.82(95%CI为0.78，0.86)，AUROC分别为0.71(95%CI为0.66，0.76)、0.72(95%CI为0.67，0.77)、0.77(95%CI为0.72，0.81)。尽管Cirrh模型显示AUROC为0.85(95%CI为0.80，0.91)，优于APRI和Forns‘s指数，但C5a+FIB-4的AUROC为0.94(95%CI为0.90，0.97)。在慢性乙肝感染者中，血清C5a浓度在严重纤维化阶段和早期肝硬变时显著降低。在评估显著纤维化和早期肝硬化方面，FIB模型和C5a+FIB-4分别比现有模型表现得更好。本文的在线版本(doi：10.1007/s15010-0160942-7)包含补充材料，授权用户可以使用。
To investigate the association between serum complement 5a (C5a) concentration and liver fibrosis and cirrhosis in a large cohort of patients chronically infected with hepatitis B virus (HBV). Five hundred and eight patients with chronic HBV infection undergoing liver biopsy were included. Serum concentrations of C5a was measured by Luminex screening system. Ishak histological system was obtained. C5a levels were negatively associated with liver fibrosis stages and significantly declined in patients with severe fibrosis and cirrhosis (P < 0.001). Multiple analysis showed C5a, AST, laminin, Co-IV, platelet count, albumin, HBsAg associated with liver fibrosis independently. Based on the markers above, we created two scores, Fib-model for significant fibrosis and Cirrh-model for earlier cirrhosis. Fib-model was performing better to differentiate from significant fibrosis, with an AUROC of 0.82 (95 % CI 0.78, 0.86), in comparison to existed models APRI, FIB-4 and Forns’ index with AUROCs of 0.71 (95 % CI 0.66, 0.76), 0.72 (95 % CI 0.67, 0.77), 0.77 (95 % CI 0.72, 0.81), respectively. Although, Cirrh-model showed AUROC of 0.85 (95 % CI 0.80, 0.91) for evaluation of earlier cirrhosis, superior to APRI, and Forns’ index, C5a + FIB-4 performed best with an AUROC of 0.94 (95 % CI 0.90, 0.97). In patients with chronic HBV infection, serum C5a concentration significantly decreased in severe fibrosis stages and earlier cirrhosis. Fib-model and C5a + FIB-4 performed better than existed models for assessment of significant fibrosis and earlier cirrhosis, respectively. The online version of this article (doi:10.1007/s15010-016-0942-7) contains supplementary material, which is available to authorized users.
影响因子：
7.4
作者：
White IR;Patel K;Symonds WT;Dev A;Griffin P;Tsokanas N;Skehel M;Liu C;Zekry A;Cutler P;Gattu M;Rockey DC;Berrey MM;McHutchison JG
通讯作者：
McHutchison JG