Roles of MCV,RDW and SAA in the progression of chronic hepatitis B

doi:10.3969/j.issn.1673-8640.2020.11.016

Abstract

Abstract:

Objective To investigate the roles of mean corpuscular volume（MCV）,red blood cell distribution width（RDW）and serum amyloid A（SAA） in the progression of chronic hepatitis B. Methods Totally,198 patients with different liver diseases and 39 healthy subjects were enrolled. The patients included 50 cases of chronic hepatitis B,56 cases of liver cirrhosis and 92 cases of hepatocellular carcinoma. Receiver operating characteristic（ROC） curve were used to evaluate the diagnostic values of MCV,RDW and SAA in liver cirrhosis and hepatocellular carcinoma. The correlations between SAA and clinicopathological characteristics were analyzed. Results MCV,RDW and SAA in different liver disease groups were higher than those in healthy control group（P<0.05）,MCV and RDW in liver cirrhosis group were higher than those in chronic hepatitis B group（P<0.05）,SAA in hepatocellular carcinoma group was higher than that in chronic hepatitis B（P<0.05）,MCV and RDW in liver cirrhosis group were higher than those in hepatocellular carcinoma group（P<0.05）,and SAA was lower（P<0.05）. The sensitivities of MCV,RDW,SAA and the combined determination for the diagnosis of liver cirrhosis were 60.71%,87.50%,78.57% and 92.86%,respectively,and the specificities were 80.68%,69.32%,71.59% and 72.73%,respectively. The sensitivities and specificities of MCV,RDW and SAA in the diagnosis of hepatocellular carcinoma were 40.22%,67.36%;58.70%,58.33%;53.26%,92.36%,respectively. There was no correlation between SAA and patients' sex,tumor number and vascular invasion in hepatocellular carcinoma group（P>0.05）,while there were correlations between SAA and tumor size and extrahepatic metastasis（P<0.05）. Conclusions MCV,RDW and SAA are sensitive indicators of hepatitis B-related liver cirrhosis. SAA is highly specific for the diagnosis of hepatocellular carcinoma and is closely related to tumor size and extrahepatic metastasis. The determinations of MCV,RDW and SAA are fast and convenient,which have practical application value in the follow-up and monitoring progress of patients with chronic hepatitis B.

Key words: Mean corpuscular volume, Red blood cell distribution width, Serum amyloid A, Chronic hepatitis B

CLC Number:

R446.1

GUO Ping, ZHUANG Lihua, CHEN Liting, WANG Jianbiao, WU Jianfeng. Roles of MCV,RDW and SAA in the progression of chronic hepatitis B[J]. Laboratory Medicine, 2020, 35(11): 1153-1157.

Figures/Tables 6

References 20

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组别	MCV/fL	RDW/%	SAA/（mg/L）
正常对照组	91.2（89.2~93.0）	13.0（12.7~13.3）	4.9（4.8~5.3）
慢乙肝组	93.2（90.1~96.4）^*	14.5（13.2~16.4）^*	5.6（5.1~6.4）^*
慢乙肝后肝硬化组	96.6（92.9~102.7）^*#	15.9（14.9~17.2）^*#	7.1（5.9~8.2）^*#
慢乙肝后肝细胞癌组	93.9（89.3~98.1）^*△	15.0（13.5~16.2）^*△	9.4（6.7~21.4）^*#△

组别	MCV/fL	RDW/%	SAA/（mg/L）
正常对照组	91.2（89.2~93.0）	13.0（12.7~13.3）	4.9（4.8~5.3）
慢乙肝组	93.2（90.1~96.4）^*	14.5（13.2~16.4）^*	5.6（5.1~6.4）^*
慢乙肝后肝硬化组	96.6（92.9~102.7）^*#	15.9（14.9~17.2）^*#	7.1（5.9~8.2）^*#
慢乙肝后肝细胞癌组	93.9（89.3~98.1）^*△	15.0（13.5~16.2）^*△	9.4（6.7~21.4）^*#△

项目	曲线下面积	最佳临界值	敏感性/%	特异性/%	95%可信区间
MCV	0.71	95.35	60.71	80.68	0.61 ~0.81
RDW	0.83	14.25	87.50	69.32	0.76 ~0.89
SAA	0.78	5.85	78.57	71.59	0.69~ 0.86
MCV+RDW+SAA	0.87		92.86	72.73	0.82~ 0.93

项目	曲线下面积	最佳临界值	敏感性/%	特异性/%	95%可信区间
MCV	0.71	95.35	60.71	80.68	0.61 ~0.81
RDW	0.83	14.25	87.50	69.32	0.76 ~0.89
SAA	0.78	5.85	78.57	71.59	0.69~ 0.86
MCV+RDW+SAA	0.87		92.86	72.73	0.82~ 0.93

项目	曲线下面积	最佳临界值	敏感性/%	特异性/%	95%可信区间
MCV	0.49	95.75	40.22	67.36	0.42~0.57
RDW	0.54	14.85	58.70	58.33	0.47~0.62
SAA	0.78	9.28	53.26	92.36	0.72~0.85