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乙型肝炎病毒前S1抗原与e抗原、乙型肝炎病毒DNA的相关性分析
侯晓菁,梁艳,何凤春,陈洁,崔艳芳,仲人前,王皓*
0
(第二军医大学长征医院实验诊断科,上海 200003)
摘要:
目的:探讨乙肝病毒(HBV)前S1(Pre-S1)抗原与e抗原(HBeAg)、HBV DNA含量的相关性,以评价Pre-S1抗原检测HBV复制的临床应用价值。方法:临床采集乙肝表面抗原阳性标本363例,以ELISA法检测Pre-S1抗原,时间分辨免疫荧光法检测HBeAg,实时荧光定量PCR(FQ-PCR)法检测HBV DNA含量,并对Pre-S1抗原、HBeAg和HBV DNA检测结果进行相关性分析。结果:Pre-S1抗原与HBeAg值之间存在关联性(χ2=94.4,P<0.01),关联系数为0.45;Pre-S1抗原与HBV DNA亦有关联(χ2=198.58,P<0.01),关联系数为0.59。Pre-S1抗原阳性率随HBV DNA含量的增加而增加。当HBV DNA拷贝数的对数值>3时,Pre-S1抗原的诊断敏感度84.5%,特异性91.2% ,准确性87.0%,阳性预测值94.1%,阳性似然比9.6,优势比56.8;HBeAg诊断敏感度50.4%,特异性94.9%,准确性67.2%,阳性预测值94.2%,阳性似然比9.8,优势比18.9。结论:Pre-S1抗原与HBV DNA具有相关性,Pre-S1抗原较HBeAg能更敏感、更准确地反映HBV复制情况,三者联合检测互相补充,更有助于临床疾病的诊治。
关键词:  肝炎病毒,乙型  前S1抗原  e抗原  DNA
DOI:10.3724/SP.J.1008.2007.01306
投稿时间:2007-09-17修订日期:2007-10-10
基金项目:
Correlation analysis between HBV Pre-S1 antigen with HBeAg and HBV DNA
HOU Xiao-jing, LIANG Yan, HE Feng-chun, CHEN Jie,CUI Yan-fang,ZHONG Ren-qian, WANG Hao*
(Department of Laboratory Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China)
Abstract:
Objective:To study the correlation between HBV Pre-S1 antigen, HBeAg levels and HBV DNA copies, so as to assess the clinical value of Pre-S1 in detection of HBV replication. Methods: A total of 363 HBsAg-positive samples were collected. The levels of Pre-S1 antigen, HBeAg and HBV DNA copies were determined by ELISA, time-resolved immuno-fluorescent method and real-time fluorescent quantitative PCR(FQ-PCR),respectively. The correlation between the determination results was analyzed. Results: Pre-S1 antigen level was correlated with the level of HBeAg (χ2=94.4,P<0.01), with the coefficient being 0.45; Pre-S1 antigen level was also correlated with HBV DNA(χ2=198.58, P<0.01), with the coefficient being 0.59. The positive rate of Pre-S1 increased with HBV DNA copies. When logarithm of HBV DNA copies was more than 3, the sensitivity, specificity, accuracy, positive predictive value(PPV), positive likelihood ratio(PLR) and odds ratio(OR) of Pre-S1 were 84.5%,91.2%,87.0%,94.1%,9.6,and 56.8 respectively;the numbers of HBeAg were 50.4%,94.9%,67.2%,94.2%,9.8 and 18.9, respectively. Conclusion: Pre-S1 antigen is correlated with HBV DNA and is more sensitive and accurate than HBeAg in reflecting HBV replication. The above 3 parameters can complement each other and the combination of them is more accurate in clinical diagnosis.
Key words:  hepatitis B virus  pre-S1 antigen  e antigen  DNA