CN107328937A - For the construction method for the practicality model for evaluating hepatitis B hepatopathy NK cell functions - Google Patents
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Abstract
The invention provides a kind of construction method for being used to evaluate the practicality model of hepatitis B hepatopathy NK cell functions, it includes:(1) hepatitis B hepatopath is divided into chronic hepatitis of active stage patient and chronic hepatitis nonmobile phase patient, the frequency disribution of peripheral blood NK cell and its subgroup is detected using Flow Cytometry, and be compared;(2) cytokine levels of peripheral blood NK cell and its subgroup secretion are detected using Flow Cytometry, and are compared;(3) clinical indices of patient are collected, clinical indices and NK cellular immunities evaluation index are subjected to correlation analysis;(4) enlivened with NK cell functions and NK cell functions are low for feedback variable, the index relevant with patient's NK cell function states is gone out using multipie logistic regression model discrimination;(5) assessment models are set up;(6) nomogram is built.
Description
Technical field
The invention belongs to biomedical sector, and in particular to a kind of practicality for being used to evaluate hepatitis B hepatopathy NK cell functions
Model and its construction method.
Technical background
NKT (natural killer, NK) cell is the important immunocyte of body, from unlike T cell its
Killing activity is limited without MHC, independent of antibody, therefore referred to as Nk Cell Activity cell;NK cells are resisting tumour, antiviral
Infection and immunological regulation play a significant role, be human defense's pathogen invasion and internal cytometaplasia occur first prevent
Line.According to the difference of NK cell surface CD56 density, CD56 can be classified asbrightAnd CD56dimTwo kinds of hypotypes.The work(of NK cells
It can include:(a) Nk Cell Activity:Target cell is recognized by non-specificity and killing medium, such as perforin is discharged
(Perforin), NK cytotoxic factors, TNF (TNF-α) etc..NK cell activations are by inhibition and Activating receptor
Between balance controlled.(b) secrete cytokines, the NK cells of activation can synthesize and secrete cytokine profiles, and performance is exempted from
Epidemic disease adjustment effect.
NK cells are very abundant in normal liver, account for the 31% of liver endolymph cell.NK cells are in liver in microenvironment
Cytokine mediated, including IL-2, IL-12, IFN-γ;NK cells cause liver thin as effector cell through FasL-Fas systems
Contain perforin and granzyme in born of the same parents' apoptosis, cytoplasmic granule, and secrete cytokines IFN-γ and TNF-α suppress pathogenic infection
Or tumour.Therefore, NK cells are removing tumour cell, virus infected cell, some autologous tissue's cells (such as haemocyte), parasitism
Worm etc. plays key player, is that body is antitumor, one of anti-infectious important immune factor main defence line, especially chronic
The serious disease progressive stage such as inflammation, tumour, internal T cell function is collapsed, and the effect of NK cells is even more important.Therefore, it is objective
Evaluate NK cell functions most important to morbid state assessment, medicine for treatment guidance, Index for diagnosis.
However, lacking the clinical detection model for evaluating hepatopathy NK cell general functions at present.
Liver is the maximum immune organ of human body, and pathologic liver is full of and infiltrated a large amount of immunocytes, clinical liver disease knot
Office and the reparation and improvement of vivo immunization function are closely bound up.However, in many chronic liver diseases and liver cancer patient body, with life
The development of life group, the correlation technique of immune system is constantly improved, and immunoglobulin, complement since the seventies etc. are determined,
The immune state of body can be estimated roughly and indirectly, progressively substituted by the detection of lymphocyte subgroup, cell factor, generation
The detection means of table includes:(1) biological method detected based on DNA, such as PCR, RNA trace, in situ hybridization technology, this
Class method can be detected to single immune cell factor, and study its regulatory pathway, but should not be used as clinical complicated case
Differentiation;(2) bioactivity detection method, such as ELISA, ELISPOT, this kind of method is only to single cell or single immune
Cell-secretion factor is detected, rather than the mean cytokine levels of certain a group immunocyte are detected, equally, also not
Beneficial to the differentiation as clinical complicated case;(3) Flow Cytometry and liquid chip detection:This is more accurately to examine at present
Multiple cell factors can be detected, clinician is according to immune state of the different cytokines level to patient by survey technology
Estimated, but be not directed to immunocyte general function evaluation.
It can be seen that, the method that all detection techniques of the above are all evaluated without reference to immunocyte general function, while can not
Multiple cell factors are detected, so that clinician is carried out in advance according to different cytokines level to the immune state of patient
Estimate, and with stronger subjectivity, fairly expensive, cumbersome, it is impossible to extensive use.
The content of the invention
The purpose of the present invention is that the technical problem to be solved simply and easily is used to evaluate second there is provided a kind of for more than
The construction method of the practicality model of liver hepatopathy NK cell functions, the assessment models built by this method being capable of accurate evaluation second
The general function of liver hepatopathy NK cells.
In order to realize above goal of the invention, the invention provides a kind of practicality for being used to evaluate hepatitis B hepatopathy NK cell functions
The construction method of property model, it includes:
(1) hepatitis B hepatopath is divided into chronic hepatitis of active stage patient (CA) and chronic hepatitis nonmobile phase patient
(CAN) frequency disribution of peripheral blood NK cell and its subgroup, is detected using Flow Cytometry, and carries out the comparison between two groups;
(2) cytokine levels of peripheral blood NK cell and its subgroup secretion are detected using Flow Cytometry, and are carried out
Comparison between two groups;
(3) the clinical indices demography of patient, virology, liver function, liver hardness values are collected, by clinical indices with
NK cellular immunities evaluation index carries out correlation analysis, finds out the clinical indices of Close relation;
(4) enlivened with NK cell functions and NK cell functions are low for feedback variable, utilize multipie logistic regression
Model filters out the index relevant with patient's NK cell function states from 14 clinic easily obtained-virology indexs.It is preferred that
Ground, the method for screening is progressively Variable Selection method, and the standard of screening is AIC.In another preferred embodiment, using about stepping on
Index (Youden Index), determines the optimal cutoff values for the probability that patient immune function is active group, patient is divided into
NK cell functions active group and low group of NK cell functions;
(5) with Age, Fibriscan, HBeAg, HBcAb, ALB clinic-virology Index Establishment assessment models:
Estimate | Std.Error | Pr(>|z|) | |
(Intercept) | 8.079761402 | 4.561524966 | 0.076513297 |
age | 0.025878032 | 0.028016963 | 0.355665519 |
fibriscan | 0.372221664 | 0.159550049 | 0.019650975 |
HBeAg | -0.000459896 | 0.000281939 | 0.102850506 |
HBcAb | -2.41486034 | 0.585470381 | 3.71E-05 |
ALB | -0.184567872 | 0.089708896 | 0.039646921 |
Wherein, Age is the age;Fibriscan is liver hardness number;HBeAg is hepatitis B E antigens;HBcAb is anti-for hepatitis B core
Body;ALB is albumin.
(6) nomogram is built, the clinical practice type equation for evaluating NK cell functions is obtained, uses routine clinical index
The general function state of NK cells is pointed out indirectly.
Preferably, construction method of the invention also includes verification step.
It is highly preferred that the construction method of the present invention carries out external certificate using new patient's queue to model.
Preferably, the clinical practice type equation for evaluating NK cell functions is:
By calculating, the numerical value obtained is compared with cutoff values (0.0361),>=0.0361 represents that N cell functions are lived
Jump;It is low for NK cell functions less than 0.0361.
Compared with prior art, method of the invention is built Model Practical, conveniently, simply, being capable of each NK of effective evaluation
Cell entirety immune state, is that clinical state assessment, immunization therapy and antiviral therapy etc. provide indirect reference, promotes hepatopathy
Diagnosis and treatment further precision.
Brief description of the drawings
Fig. 1 shows the frequency disribution for NK cells and its hypotype.
Fig. 2 shows NK cells and its subgroup secretion activity cell factor IFN-γ and TNF-α analysis.
Fig. 3 indicates NK cells and its hypotype secretes correlation between each cell factor and clinical virology index.
Fig. 4 shows ROC curve analysis chart.
Fig. 5 shows nomogram.
Fig. 6 shows the constructing technology route map of the applied model of NK cell functions.
Embodiment
With reference to specific embodiments and the drawings, technical scheme is further described, but the present invention is not
It is limited to following examples.Such as unspecified, involved in the present invention detection technique, such as flow cytometry is known in the art
Technology.
In view of the deficiency of immunologic function detection means at present, invention thinking of the invention is:By thin to hepatopath NK
Born of the same parents and its reactivity cell factor of subgroup secretion, mainly IFN-γ and TNF-α;Progress passes through list on cellular and molecular level
Clonal antibody carries out multi-parameter, quick quantitative analysis to individual cells or other biological particle and detected;Then statistical analysis,
The overall immune state of NK cells of each natural history period patient is reappraised, and converts and establishes that can to assess NK cells overall
The clinical practice Rating Model of immune state.It is intended to using this easy, practicality model, it is overall that individuation evaluates patient NK cells
Immune state, is that clinical state is assessed, immunization therapy and antiviral therapy etc. provide reference, promotes the diagnosis and treatment of hepatopathy towards precision
Further.
Generally, method of the invention is related to as follows:
1st, queue is studied:800 hepatitis B hepatopaths are included, diagnostic criteria was with reference to U.S.'s hepatopathy Guide to research in 2016.
Verify queue:300 hepatopaths.
2nd, study population is grouped according to above-mentioned guide:Chronic hepatitis of active stage patient (CA, 400) and Chronic Liver
Scorching nonmobile phase patient (CAN, 400);Utilize Flow Cytometry detection peripheral blood NK cell subgroup frequency (total NK
cells,NKdim cells and NKbrightCells) and secretion cell factor (IFN-γ and TNF-αs), and carry out two
Comparison between group.As shown in figure 1, being NK cells and its frequency disribution of hypotype.Wherein, the A in Fig. 1 shows representational NK
Cell streaming detection technique;B, C, D respectively illustrate overall NK cells and its subgroup (NKdimAnd NKbright) in two groups of hepatopathys
Level compare.CA is chronic hepatitis of active stage study subject, and CAN is chronic hepatitis nonmobile phase study subject, and HC is health
Control.
3rd, the cytokine levels of peripheral blood NK cell and its subgroup secretion are detected using Flow Cytometry, and carry out two
Comparison between group.As shown in Fig. 2 being NK cells and its analysis of subgroup secretion activity cell factor IFN-γ and TNF-α.Wherein,
A in Fig. 2, which is shown, compares NK cells and the reactivity factor level of subgroup secretion in chronic liver disease;B then shows two groups of diseases
The distribution map of example NK cells and its subgroup secretion of gamma-IFN and the level of TNF-α.
4th, the data such as the demography of each case, virology, liver function, liver hardness values in collection research queue,
Clinical indices and NK cellular immunities evaluation index are subjected to correlation analysis, the clinical indices of Close relation are found out.Such as Fig. 3
It is shown, it is the surface of NK cells and its subgroup secrete cytokines (reactivity cell factor, the inhibitory cells factor) and expression
Acceptor (Activating receptor, Inhibitory receptor) and the correlation analysis of clinical indices.Wherein dark-shaded shows that two kinds have phase
Guan Xing, correlation is stronger, and color is deeper;Blank then represents that correlation is not present.
5th, with NK cell functions active (high NK activity, NK-H) and low (the low NK of NK cell functions
Activity, NK-L) it is feedback variable, the clinic-virology easily obtained from 14 using multipie logistic regression model
The index relevant with patient's NK cell function states is filtered out in index.The method of screening is progressively Variable Selection method, screening
Standard is AIC.Using youden index (Youden Index), it is determined that " patient immune function is High group probability " is most
Patient, is divided into excessive risk group and low-risk group by good cutoff values.As shown in figure 4, being ROC curve analysis chart:Chronic liver disease
In sift out tool significance clinical indices, specificity and sensitivity analysis as indirect assessment NK cell functions.Institute
The AUC areas for having research object are 0.818, and the AUC areas of non-hepatitis active patient group are 0.7608.
6th, 4 important clinic-virology indexs (Fibrosis value, HBsAg, HBcAb, ALB) are finally given:Build
Vertical assessment models:
Estimate | Std.Error | Pr(>|z|) | |
(Intercept) | 8.079761402 | 4.561524966 | 0.076513297 |
age | 0.025878032 | 0.028016963 | 0.355665519 |
fibriscan | 0.372221664 | 0.159550049 | 0.019650975 |
HBeAg | -0.000459896 | 0.000281939 | 0.102850506 |
HBcAb | -2.41486034 | 0.585470381 | 3.71E-05 |
ALB | -0.184567872 | 0.089708896 | 0.039646921 |
7th, nomogram (nomograms) is built, the clinical practice type equation for evaluating NK cell functions is obtained, using normal
Rule clinical indices point out the general function state of NK cells indirectly.
Nomogram is as shown in Figure 5.
Clinical practice type equation for evaluating NK cell functions is:
By calculating, the numerical value obtained is compared with cutoff values (0.0361),>=0.0361 represents that N cell functions are lived
Jump;It is low for NK cell functions less than 0.0361.
8th, external certificate is carried out to assessment models using new patient's queue.
Application Example
Example one:Routine clinical biochemistry detection is carried out to 12 Chronic Hepatitis Bs, its NK cellular immune function is understood:
The partial clinical index of 12 cases is as follows:
Case/index | Age | HBeAg | HBcAb | ALB | Fibrosis |
1 | 33 | 34 | 1.6 | 43 | 5.4 |
2 | 23 | 2 | 10.7 | 44 | 5.2 |
3 | 25 | 46 | 32.5 | 43 | 6.2 |
4 | 45 | 35 | 0.007 | 39 | 7.8 |
5 | 34 | 36 | 4.5 | 51 | 6.3 |
6 | 38 | 0.34 | 0.3 | 48 | 6.8 |
7 | 54 | 0.45 | 0.67 | 41 | 4.7 |
8 | 62 | 0.63 | 0.76 | 43 | 3.5 |
9 | 25 | 47 | 21.2 | 49 | 8.5 |
10 | 41 | 0.32 | 0.056 | 41 | 12.3 |
11 | 67 | 0.32 | 0.045 | 40 | 9.8 |
12 | 45 | 0.12 | 0.021 | 39 | 6.9 |
(2) assessment models (Vnk models) of the invention more than, the NK cell functions detected value of 12 cases is such as
Under:
Case | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 |
Vnk | 0.2944 | 8.6199 | -28.1683 | 0.9927 | 0.0001 | 0.8818 | 0.8850 | 0.7712 | 4.6581 | 0.9976 | 0.9975 | 0.9887 |
(3) it is 0.0361, Vnk according to the cutoff values of Vnk models>=0.0361 represents that NK cell functions are normal or active
(NK-H);Vnk<0.0361 represents that NK cell functions are low (NK-L), and the NK cell functions state of above-mentioned case is judged such as with this
Under:
Example two:Hepatitis B liver cancer patient, male, 35 years old, check clinical indices in operative treatment half a year, carry out virology and
The sequence inspection of biochemical indicator, timing node is:0 week, 12 weeks, 24 weeks.
(1) clinical indices are as follows:
(2) according to the NK cell function evaluation models of the present invention, in the Vnk values of different time points, i.e. NK cellular immunities work(
Energy testing result is as follows:
Treatment time point | 0 week | 12 weeks | 24 weeks |
Vnk | 0.9255 | 0.9426 | 0.9871 |
(3) it is 0.0361, Vnk according to the cutoff values of Vnk models>=0.0361 represents that NK cell functions are normal or active
(NK-H);Vnk<0.0361 represents that NK cell functions are low (NK-L), and the NK cell functions state of above-mentioned case is judged such as with this
Under:
Therefore, from above example it can be confirmed that the NK cell application assessment models of the present invention not only may determine that single
The overall immune functional state of instantaneous NK cells;Further, the NK in non-treatment or therapeutic process can be monitored
The variation tendency of cell entirety immunologic function;Because the present invention builds single thin based on advanced Flow Cytometry and airflow classification
The detection technique of born of the same parents, numerical value is true and reliable;Biochemical, virology index is merged again, using the computational methods of biometrics big data,
The structure of model is carried out, it is convenient, practical, accurate.
It is worth noting that, the method for the present invention is intended to build the mould for being used for detecting and assess NK lymphocyte immunity states
Type, direct purpose is only in that acquisition intermediate result, and the diagnosis of the intermediate result and disease or health status have no direct certainty
Contact.Treatment and diagnosis for hepatitis B diseases are, it is necessary to the numerous parameters of overall merit, including are not limited to Hepatitis B Surface and resist
The multinomial serology response such as original, surface antibody, e antigens, e antibody, core antibody, pre S 1 antigen level and biochemical response,
And the NK lymphocyte immunities state only known via model involved in the present invention directly can not be detected and/or examined
Disconnected hepatitis B diseases.
Claims (6)
1. a kind of construction method for being used to evaluate the practicality model of hepatitis B hepatopathy NK cell functions, it is characterised in that including:
(1) hepatitis B hepatopath is divided into chronic hepatitis of active stage patient and chronic hepatitis nonmobile phase patient, it is thin using streaming
The frequency disribution of born of the same parents' technology for detection peripheral blood NK cell and its subgroup, and carry out the comparison between two groups;
(2) cytokine levels of peripheral blood NK cell and its subgroup secretion are detected using Flow Cytometry, and carry out two groups
Between comparison;
(3) the clinical indices demography of collection patient, virology, liver function, liver hardness values, thin with NK by clinical indices
Born of the same parents' immunity evaluation index carries out correlation analysis, finds out the clinical indices of Close relation;
(4) enlivened with NK cell functions and NK cell functions are low for feedback variable, utilize multipie logistic regression model
The index relevant with patient's NK cell function states is filtered out from multiple clinic-virology indexs easily obtained;
(5) with Age, Fibrosis detected value, HBeAg, HBcAb, ALB clinic-virology Index Establishment assessment models:
Wherein, Age is the age;Fibriscan is liver hardness number;HBeAg is hepatitis B E antigens;HBcAb is hepatitis B core antibody;
ALB is albumin;
(6) nomogram is built, the clinical practice type equation for evaluating NK cell functions is obtained, it is indirect using routine clinical index
Point out the general function state of NK cells.
2. according to the method described in claim 1, it is characterised in that also including verification step.
3. method according to claim 2, it is characterised in that:External certificate is carried out to model using new patient's queue.
4. according to the method described in claim 1, it is characterised in that:Clinical practice type equation for evaluating NK cell functions
For:
5. according to the method described in claim 1, it is characterised in that:In the step (4), the method for screening is that progressively variable is sieved
Method is selected, the standard of screening is AIC.
6. according to the method described in claim 1, it is characterised in that:In the step (4), determine that patient exempts from using youden index
Epidemic disease function is the optimal cutoff values of the probability of active group, and the critical value is 0.0361, and patient, which is divided into NK cell functions, to live
Jump group and low group of NK cell functions.
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CN111312387A (en) * | 2020-01-16 | 2020-06-19 | 安徽医科大学第一附属医院 | Model for predicting severity of pain of male chronic prostatitis/chronic pelvic pain syndrome and establishment of model |
CN112336358A (en) * | 2020-04-30 | 2021-02-09 | 中山大学孙逸仙纪念医院 | Model for predicting malignant risk of breast lesion of compact breast and construction method thereof |
CN112885473A (en) * | 2021-04-16 | 2021-06-01 | 杭州普罗亭医学检验实验室有限公司 | Pan-disease risk prediction system combining high-dimensional immunity with big data and artificial intelligence |
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