文章摘要
张 强,侯丹杰,张爱辉,张 生,潘伟康.胆道闭锁患儿肝组织TGF-β1、CD34在肝纤维化中的作用及血清TGF-β1的诊断价值研究[J].,2020,(21):4037-4041
胆道闭锁患儿肝组织TGF-β1、CD34在肝纤维化中的作用及血清TGF-β1的诊断价值研究
The Role of TGF-β1 and CD34 in Liver Tissues on Liver Fibrosis and the Diagnostic Value of Serum TGF-β1 in Children with Biliary Atresia
投稿时间:2020-04-27  修订日期:2020-05-23
DOI:10.13241/j.cnki.pmb.2020.21.007
中文关键词: 胆道闭锁  转化生长因子-β1  白细胞分化抗原34  肝纤维化
英文关键词: Biliary atresia  TGF-β1  CD34  Liver fibrosis
基金项目:国家自然科学基金项目(81701501)
作者单位E-mail
张 强 西安市儿童医院综合外科 陕西 西安 710003 zhangqiang_xb@yeah.net 
侯丹杰 西安市儿童医院泌尿外科一病区 陕西 西安 710003  
张爱辉 西安市儿童医院胸外科 陕西 西安 710003  
张 生 西安市儿童医院普外科一病区 陕西 西安 710003  
潘伟康 西安交通大学第二附属医院小儿外科 陕西 西安 710004  
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中文摘要:
      摘要 目的:探讨转化生长因子-β1(transforming growth factor-β1,TGF-β1)和白细胞分化抗原34(Cluster of Differentiation,CD34)在胆道闭锁患儿肝组织中的表达及在肝纤维化中的作用,验证血清TGF-β1浓度对该病患儿肝纤维化的诊断价值。方法:选取2016年4月-2019年1月我院收治的胆道闭锁(Biliary atresia,BA)患儿66例作为研究组、胆管扩张症患儿30例作为对照组,比较两组肝组织中TGF-β1及CD34因子的免疫组化检测结果,以及研究组不同肝纤维化分级患儿的TGF-β1及CD34因子表达情况及其与肝纤维化分级的相关性。比较两组血清TGF-β1浓度,以及研究组不同肝纤维化分级患儿血清TGF-β1浓度情况及其与肝纤维化分级的相关性,最后绘制ROC曲线检测血清TGF-β1浓度对该病患儿肝纤维化的诊断价值。结果:研究组肝组织TGF-β1 IOD值及CD34因子表达面积均高于对照组,差异有统计学意义(P<0.05);随着研究组患儿的肝纤维化程度不断加重,TGF-β1及CD34因子的阳性表达率均不断增加,差异有统计学意义(P<0.05),且分别与肝纤维化程度呈正相关(ρ=0.594,P<0.05;ρ=0.616,P<0.05)。研究组血清TGF-β1浓度高于对照组,差异有统计学意义(P<0.05);随着研究组患儿肝纤维化程度不断加重,血清TGF-β1浓度不断增加,差异有统计学意义(P<0.05),且与肝纤维化程度呈正相关(ρ=0.944,P<0.05)。血清TGF-β1对胆道闭锁患儿肝纤维化有诊断意义(AUC=0.917,P<0.001),诊断的最佳界值为436.4 ng/L(敏感度为0.879,特异度为0.867)。结论:TGF-β1及CD34在胆道闭锁患儿肝组织的表达显著升高,提示可能通过抑制患儿TGF-β1及CD34表达进而阻止或延缓胆道闭锁所致肝纤维化进展;血清TGF-β1可用于诊断患儿胆道闭锁所致肝纤维化。
英文摘要:
      ABSTRACT Objective: To investigate the expression of transforming growth factor-1 (transforming growth factor-β1, TGF-β1) and leukocyte differentiation antigen 34 (cluster of differentiation, CD34) in the liver tissues of children with biliary atresia and the effect of TGF-β1 and CD34 in liver fibrosis, and to verify the diagnostic value of serum concentration of TGF-β1 in liver fibrosis. Methods: 66 children with biliary atresia admitted to our hospital from April 2016 to January 2019 were selected as the research group, and 30 children with biliary dilatation as the control group. The immunohistochemical detection results of TGF-β1 and CD34 in liver tissues of the two groups were then compared, the expression of TGF-β1 and CD34 in children with different grades of liver fibrosis in research group and the correlation between TGF-β1 or CD34 with the grade of liver fibrosis were respectively detected. The serum TGF-β1 concentration of the two groups were compared, the serum TGF-β1 concentration in children with different grades of liver fibrosis in research group and the correlation between it with the grade of liver fibrosis were detected, and at last the diagnostic value of serum TGF-β1 concentration in children with liver fibrosis caused by biliary atresia were measured by ROC curve. Results: The TGF-β1 IOD and expression area of CD34 in liver tissues of the research group were significantly higher than those of the control group (P<0.05). The positive expression rates of TGF-β1 or CD34 increased with the aggravation of liver fibrosis in the research group (P<0.05), and respectively had positive correlation with the degree of liver fibrosis(ρ=0.594 and P<0.05, ρ=0.616 and P<0.05). The serum concentration of TGF-β1 in the research group was significantly higher than that of the control group (P<0.05), increased with the aggravation of liver fibrosis in the research group (P<0.05), and had positive correlation with the degree of liver fibrosis(ρ=0.944 and P<0.05). The serum concentration of TGF-β1 had diagnostic significance for liver fibrosis in children with biliary atresia (AUC=0.917, P<0.001), and the best diagnostic threshold is 436.4 ng/L, of which the sensitivity is 0.879 and the specificity is 0.867. Conclusion: The expression of TGF-β1 and CD34 is significantly increased in liver tissues of children with biliary atresia, which suggest that inhibiting the expression of TGF-β1 or CD34 may prevent or delay the further development of liver fibrosis induced by biliary atresia. The serum concentration of TGF-β1 can be used to diagnose the liver fibrosis caused by biliary atresia in children.
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