2023 年第 2 期 第 18 卷

补体C1q在三种常见类型肝病中的表达及潜在临床价值

Expression and potential clinical value of complement C1q in three common types of liver diseases

作者：蔡馨李欢汤冬玲张平安

英文作者：Cai Xin Li Huan Tang Dongling Zhang Ping′an

单位：武汉大学人民医院检验科，武汉430060

英文单位：Department of Clinical Laboratory Renmin Hospital of Wuhan University Wuhan 430060 China

关键词：肝癌；肝炎；肝硬化；补体C1q；诊断

英文关键词：Hepaticcarcinoma;Hepatitis;Cirrhosis;ComplementC1q;Diagnosis

• 摘要：

• 目的 探讨补体C1q在三种常见类型肝病中的表达及临床价值。方法 收集2021年3月至2022年3月于武汉大学人民医院肿瘤科、传染科、肝胆外科诊治的287例肝病患者的临床资料行回顾性分析。根据疾病不同分为慢性肝炎组（86例）、肝硬化组（77例）和原发性肝癌组（124例）。比较3组各指标的水平，并进一步分析肝癌不同分期和不同肝炎病毒感染患者的C1q水平。探讨C1q水平与肝功能指标和凝血指标之间的相关性。利用受试者工作特征（ROC）曲线分析C1q鉴别诊断肝癌和肝硬化的价值。结果 慢性肝炎组与原发性肝癌组中C1q的表达均高于肝硬化组［（180±53）、（184±42）mg/L比（154±31）mg/L］，差异均有统计学意义（均P<0.05）。戊型肝炎病毒感染患者血清C1q水平显著高于丙型与乙型肝炎病毒感染患者［（251±54）mg/L比（168±29）、（150±25）mg/L］（均P<0.05）。晚期肝癌患者血清C1q水平显著高于早期肝癌与中期肝癌患者［（192±40）mg/L比（168±49）、（173±37）mg/L］（均P<0.05）。此外，C1q水平与部分肝功能指标和凝血指标相关，且对肝硬化与肝癌具有中等鉴别诊断价值，ROC曲线下面积为0.720，敏感度为79.22%，特异度为55.65%。结论 补体C1q能提示肝癌严重程度与不同肝炎病毒感染，在肝病中具有一定临床价值。

• Objective To investigate the expression and clinical value of complement C1q in three common types of liver diseases. Methods  The clinical data of 287 patients with liver diseases were analyzed retrospectively, who were admitted to departments of oncology, infectious disease and hepatobiliary surgery of Renmin Hospital of Wuhan University from March 2021 to March 2022. According to different diseases, they were divided into chronic hepatitis group(86 cases), cirrhosis group(77 cases) and primary hepatic carcinoma group(124 cases). The levels of clinical indexes were compared among the three groups, and the C1q levels of patients with different stages of hepatic carcinoma and different hepatitis virus infections were further analyzed. To explore the correlation between the level of C1q and the indexes of liver function and coagulation. The diagnostic value of C1q in differentiating hepatic carcinoma from cirrhosis was analyzed by receiver operating characteristic(ROC) curve analysis. Results  The expression of C1q in chronic hepatitis group and primary hepatic carcinoma group was higher than that in cirrhosis group［（180±53）, （184±42）mg/L vs （154±31）mg/L］(both P<0.05). The serum C1q level of patients with hepatitis E virus infection was significantly higher than that of patients with hepatitis C and hepatitis B virus infection［(251±54)mg/L vs (168±29), (150±25)mg/L］(both P<0.05). The serum C1q level in patients with advanced hepatic carcinoma was significantly higher than that in patients with early and intermediate hepatic carcinoma［(192±40) mg/L vs (168±49), (173±37)mg/L］(both P<0.05). In addition, the level of C1q was correlated with some indexes of liver function and coagulation, and had moderate diagnostic value for differentiating cirrhosis from hepatic carcinoma. The area under the ROC curve was 0.720, the sensitivity was 79.22%, and the specificity was 55.65%. Conclusion  Complement C1q can indicate the severity of hepatic carcinoma and different hepatitis virus infections, and has some clinical value in liver diseases.