The Association Between Serum Ceruloplasmin And Liver Pathology In Chronic Hepatitis B Infection Patients

Objective:To investigate the associations between ceruloplasmin,liver inflammation grade,fibrosis stages in patients with chronic hepatitis B(CHB),especially in chronic HBV carrier and to establish a noninvasive model to predict liver inflammation grade and fibrosis stages and analyze its diagnostic value.Methods:A retrospective study was conducted to collect 86 patients who was diagnosed chronic HBV carrier with liver biopsy as chronic HBV carrier group(group A),hospitalized from June 2010 to June 2017 in the First Affiliated Hospital of Fujian Medical University,Department of Hepatology.In the same stage,68 patients with chronic hepatitis B virus hepatitis,ULN?ALT < 2ULN and liver biopsy were named as mild abnormal group(group B).In the same stage,102 patients with chronic hepatitis B,ALT?2ULN and liver biopsy were named as significant abnormal group(group C).And collect the baseline data of the patients(age,gender,)and the clinical data,including: ceruloplasmin,five indicator test for Hepatitis B,routine blood test,and four coagulation tests,biochemical,liver inflammation grade and fibrosis stages.SPSS21.0 was used for statistical analysis,and the correlation between serum CP level and liver pathology was determined by Spearman level correlation analysis.The receiver operating characteritic curves(ROC)were used to evaluate the diagnostic value of CP on inflammation and fibrosis for chronic HBV carrier group.Logistic regression analysis was used to analyze the diagnostic significance of related indicators.A prediction model of liver inflammation grading and fibrosis stage was constructed.ROC method was used to evaluate the diagnostic value of the model and the Z test was adopted.P<0.05 showed a statistically significant difference.Results: 1.CP was negatively correlated with inflammation grading of chronic HBV carrier group(r=-0.358,P<0.01),and CP was negatively correlated with fibrosis stage of chronic HBV carrier group(r=-0.398,P<0.01)and mild abnormal group(r=-0.398,P<0.01).2.There was no significant difference in serum CP in all ages(F=1.096,P=0.351);There was no significant difference in CP among the inflammation grading(F=0.244,P=0.784).There was statistical significance(F=5.238,P=0.000)in various fibrosis stages.3.The chronic HBV carrier group when G?1,G?2 and G?3,the area under the ROC curve was 0.710,0.667 and 0.682,and the cut-off value was 182.5,195 and 176.5mg/L.The sensitivity was 96.2%,54.2% and 50% respectively.The specificity was 40.6%,78.3% and 90.9% respectively.When G?2,noninvasive model y1 = 3.685 + 0.039 x GGT(U/L)to 0.014 x PLT(10 ^ 9 / L)to 0.013 x CP(mg/L),predict value of liver inflammation grading to a certain extent,AUC = 0.79.4.When S?2,the non-invasive model y2=6.067+0.066 * GGT(U/L)-0.018 * PLT(10 9/L)-0.017 * CP(mg/L),which has a high prediction value for liver fibrosis staging of chronic HBV carriers,AUC=0.84;5.When S = 4,noninvasive model YS4 = 2.077 + 0.063 x(GGT)0.063 x PLT(10^9 / L)to 0.003 x CP(mg/L),for chronic HBV carriers cirrhosis predict value is high,the AUC = 0.879,higher than the other four groups of model(FIB-4 = 0.680,APRI = 0.788,GP = 0.814,the AP = 0.535),and has goodr sensitivity(85.7%)and specificity(83.3%)Conclusion: 1.In chronic HBV carrier group,CP level was negatively correlated with inflammation grading,and significantly decreased when G?2,we established noninvasive diagnostic model for chronic HBV carrier group with CP and some serological indexes of liver inflammation has high diagnostic value(AUC=0.79).2.In chronic HBV carrier group,CP have statistically significant negative correlation in fibrosis stages,with CP and some serological indexes of liver we established a noninvasive diagnose model for chronic HBV carrier group of liver fibrosis and cirrhosis has high diagnostic value(AUC=0.84,0.87),the diagnosis of liver cirrhosis is superior to the common liver fibrosis model FIB-4,AP,APRI.3.The noninvasive diagnose model is set up to reflect the liver inflammation and fibrosis of chronic HBV carrier group with CP and serological indexes,can effectively improve the efficiency of diagnosis and reduce the demand of liver biopsy.