寡糖链检测在乙肝相关早期肝细胞癌中的预警价值研究

The Warning Value of Glycan-Test in the Diagnosis of Hepatitis B Virus-Associated Early Hepatocellular Carcinoma

摘要: 目的：探讨寡糖链检测在乙肝相关早期肝细胞癌中的预警价值。方法：收集2020年7月至2022年2月青岛大学附属医院感染科就诊并符合纳入与排除标准的224例HBV感染患者的血清及相关资料，定量资料以中位数(四分位间距)表示，两组间比较采用Wilcoxon秩和检验；定性资料用百分比(%)表示，用卡方检验进行比较。按照寡糖链检测(Glycan-Test, G-Test)结果分为G-Test(+)患者58例，G-Test(−)患者166例，对其随访观察半年，通过半年内肝癌发生率比较评价寡糖链检测的预警价值。结果：随访观察半年，G-Test(+)患者中有12名诊断为肝癌，发病率为20.7% (12/58)；G-Test(−)患者中则有6名诊断肝癌，发病率为3.6% (6/166)；两组间差异具有统计学意义(P < 0.001)。224例患者中AFP(+) 24例，G-Test(+) 58例，随访观察半年，AFP(+)患者中有6例发生肝癌，G-Test(+)患者中有12例发生肝癌，发病率分别为25.0%、20.7%，差异无统计学意义(P > 0.05)。AFP(−)的200例患者中G-Test(+) 44例，G-Test(−) 156例，随访半年，44例患者中有8人发生肝癌，发病率为18.2%；156例患者中有4人发生肝癌，发病率为2.6%；差异具有统计学意义(P < 0.001)。结论：对乙肝相关肝癌高风险人群行寡糖链检测能够提高肝细胞癌的早期发现，降低漏诊率。

Abstract: Objective: To investigate the early warning value of Glycan-Test in hepatitis B virus-associated early hepatocellular carcinoma. Methods: 224 serum samples and clinical data were collected from the patients with HBV infection who met inclusion and exclusion criteria and were admitted to the Af-filiated Hospital of Qingdao University from July 2020 to February 2022. Quantitative variables were presented as median (25th-75th percentiles), median values of two groups were compared by the Wilcoxon test; qualitative variables were expressed as percentage (%) and compared by the chi-squared test. Among them, 58 cases were Glycan-Test positive patients, 166 cases were Gly-can-Test negative patients. For follow-up observation for half a year, the early warning value of Gly-can-Test was evaluated by comparing the incidence of liver cancer within six months. Results: After half a year of follow-up, 12 cases of the Glycan-Test positive patients were diagnosed with liver can-cer, with an incidence of 20.7% (12/58); 6 cases of the Glycan-Test negative patients were diag-nosed with liver cancer, and the incidence was 3.6% (6/166). The difference between the two groups was statistically significant (P < 0.001). Among the 224 patients, there were 24 AFP positive cases and 58 Glycan-Test positive cases. After six months of follow-up observation, there were 6 cases of liver cancer in AFP positive patients and 12 cases of liver cancer in Glycan-Test positive pa-tients, with the incidence of 25.0% and 20.7%, respectively, and the difference was not statistically significant (P > 0.05). There were 44 Glycan-Test positive cases and 156 Glycan-Test negative cases in 200 AFP negative patients, and 8 of the 44 patients developed liver cancer with an incidence of 18.2%. Among the 156 patients, 4 cases developed liver cancer, with an incidence of 2.6%. The dif-ference between them was statistically significant (P < 0.001). Conclusion: The Glycan-Test can im-prove the early detection of hepatocellular carcinoma, and reduce the rate of missed diagnosis in high risk population of hepatocellular carcinoma.