血清腱糖蛋白-C和多种肝纤维化指数诊断慢性乙型肝炎患者肝纤维化效能研究*

doi:10.3969/j.issn.1672-5069.2026.02.007

Abstract

Abstract: Objective The aim of this study was to explore the diagnostic performance of serum tenascin-C (TN-C) level as well as gamma-glutamy transpeptidase-to-platelet ratio (GPR), aspartate transaminase-to-platelet ratio index (APRI),non-alcoholic fatty liver disease fibrosis score (NFS), fibrosis index based on four factors (FIB-4) and S index for liver fibrosis (LF) in patients with chronic hepatitis B (CHB). Methods A total of 163 patients with CHB were enrolled in our hospital between January 2021 and December 2024, and all underwent percutaneous liver biopsy. Serum and blood tests were routinely performed to calculate LF indexes. Serum TN-C level was detected by ELISA, the influencing factors of advanced liver fibrosis (ALF) was analyzed by multivariate Logistic regression analysis, and the diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curves. Results Of the 163 patients with CHB, the liver histo-pathological examination found no LF in 50 cases, significant LF (SLF) in 52 cases and ALF in 48 cases; serum TN-C level, GPR, APRI, NFS, FIB-4 and S index in patients with ALF were (62.4±9.1)ng/mL, (0.6±0.2), (1.0±0.3), (-0.3±0.1), (3.1±0.7) and (1.2±0.2), all significantly higher than [(37.5±5.2)ng/mL, (0.2±0.1), (0.7±0.2), (-1.0±0.4), (0.8±0.2) and (0.4±0.1), respectively, P＜0.05] in patients with SLF; Logistic regression analysis showed that increased serum TN-C level as well as GPR, APRI, NFS, FIB-4 and S index were all the independent risk factors for ALF in patients with CHB (P＜0.05); the AUC was 0.915, with sensitivity of 98.4% and specificity of 61.8% when combination of serum TN-C level and LF indexes mentioned above in predicting ALF in patients with CHB. Conclusion The combination of serum TN-C level and GPR, APRI, NFS, FIB-4 and S index in diagnosing ALF in patients with CHB is satisfactory, which needs further clinical investigation.

Key words: Hepatitis B, Liver fibrosis, Tenascin-c, Gamma-glutamy transpeptidase-to-platelet ratio, Aspartate transaminase-to-platelet ratio index, NAFLD fibrosis score, Fibrosis index based on four factors, S index, Diagnosis

Huang Yanfang, Li Yuan, Li Zheng, et al. Diagnostic performance of serum tenascin-C level and various liver fibrosis indexes for liver fibrosis in patients with chronic hepatitis B[J]. Journal of Practical Hepatology, 2026, 29(2): 187-190.

References

[1] Tseng TC, Liu CJ, Yang WT, et al. Serum hepatitis B core-related antigen level stratifies risk of disease progression in chronic hepatitis B patients with intermediate viral load. Aliment Pharmacol Ther,2021,53(8):908-918.
[2] Friedman SL,Pinzani M. Hepatic fibrosis 2022: unmet needs and a blueprint for the future. Hepatology, 2022,75(2):473-488.
[3] Lin MT, Chang KC, Yen YH, et al. Chronic hepatitis Bexhibited higher rate of hepatocellular carcinoma occurrence than hepatitis C in cirrhotic patients after effective antiviral treatment. J Formos Med Assoc,2021,120(3):621-628.
[4] Angelini G,Panunzi S, Castagneto-Gissey L, et al. Accurate liquid biopsy for the diagnosis of non-alcoholic steatohepatitis and liver fibrosis. Gut,2023,72(2):392-403.
[5] Zuliani-Alvarez L, Piccinini AM. A virological view of tenascin-C in infection. Am JPhysiol Cell Physiol,2023,324(1):1-9.
[6] Rigamonti AE, Bondesan A, Rondinelli E,et al. The role of aspartate transaminase to platelet ratio index (APRI) for the prediction of non-alcoholic fatty liver disease (NAFLD) in severely obese children and adolescents. Metabolites,2022,12(2):155.
[7] Tao J, Li W, Ma X, et al. Diagnostic and prognostic value of aspartate transaminase-to-platelet ratio index, gamma-glutamyl transpeptidase-to-platelet ratio, and fibrosis-4 for compensated hepatitis B-related liver cirrhosis. J Coll Physicians Surg Pak,2023,33(8):941-943.
[8] 中华医学会肝病学分会,中华医学会消化病学分会,中华医学会感染病学分会.肝纤维化诊断及治疗共识(2019年).胃肠病学, 2019, 24(9):546-556.
[9] Meng Y, Zhao T, Zhang Z, et al. The role of hepatic microenvironment in hepatic fibrosis development. Ann Med,2022,54(1):2830-2844.
[10] Vachliotis ID, Vasiloglou MF, Kapama A, et al. Association between hepatic steatosis and fibrosis indices and dietary habits, physical activity, and quality of life. Arab J Gastroenterol,2022,23(4):277-287.
[11] Pang X, Hou X, Hu C, et al. Tenascin-C promotes the proliferation and fibrosis of mesangial cells in diabetic nephropathy through the β-catenin pathway. Int Urol Nephrol, 2023,55(10):2507-2516.
[12] Kjaergaard M, Lindvig KP, Thorhauge KH, et al. Using the ELF test, FIB-4 and NAFLD fibrosis score to screen the population for liver disease. J Hepatol, 2023,79(2):277-286.
[13] Abdelhameed F, Kite C, Lagojda L,et al. Non-invasive scores and serum biomarkers for fatty liver in the era of metabolic dysfunction-associated steatotic liver disease (MASLD): a comprehensive review from NAFLD to MAFLD and MASLD. Curr Obes Rep,2024,13(3):510-531.
[14] Ma J, Wei Z, Wang Q, et al. Association of serum creatinine with hepatic steatosis and fibrosis: a cross-sectional study. BMC Gastroenterol,2022,22(1):358.
[15] Luo P, Huang K, Wu D, Xu H. Correlation between miR-210 and serum levels of GGT, ALP and AST in patients with choledocholithiasis. Cell Mol Biol (Noisy-le-grand),2024,70(5):139-144.
[16] Ciornolutchii V, Ruta VM, Man AM, et al. Exploring the role of hemogram-derived ratios and liver fibrosis scores in pulmonary fibrosis. Medicina (Kaunas),2024,60(10):1702.
[17] Escouto GS, Port GZ, Tovo CV, et al. Probiotic supplementation, hepatic fibrosis, and the microbiota profile in patients with nonalcoholic steatohepatitis: a randomized controlled trial. J Nutr,2023,153(7):1984-1993.
[18] 郝岸华,杜忠彩,周林,等.慢性乙型肝炎患者肝脏硬度检测和S指数变化及评估肝纤维化程度应用价值探讨.实用肝脏病杂志, 2023, 26(5):630-633.
[19] Ghachem I, Hamzaoui L, Bachali A, et al. Performance of GPR score for non-invasive assessment of liver fibrosis in chronic hepatitis B Tunisian patients. Tunis Med, 2024,102(10):715-721.
[20] 王常鹤,朱璇,邓静,等.超声剪切波弹性成像联合AAR,APRI和FIB-4指数诊断慢性乙型肝炎患者肝纤维化程度效能研究.实用肝脏病杂志, 2025, 28(1):32-35.

Diagnostic performance of serum tenascin-C level and various liver fibrosis indexes for liver fibrosis in patients with chronic hepatitis B

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