{"id":{"repo_id":"ajou","oai_identifier":"oai:repository.ajou.ac.kr:201003/10923"},"canonical_url":"https://search.dev.ndltd.org/etd/ajou/oai:repository.ajou.ac.kr:201003/10923","repository":{"repo_id":"ajou","name":"Ajou University","base_url":"http://repository.ajou.ac.kr/oai/request"},"display":{"title":"Inter-alpha-trypsin inhibitor heavy chain H4 as a diagnostic and prognostic indicator in patients with hepatitis B virus-associated hepatocellular carcinoma","abstract":"OBJECTIVES: Inter-alpha-trypsin inhibitor heavy chain H4 (ITIH4) is associated with various diseases. We evaluated the diagnostic and prognostic significance of serum ITIH4 levels in healthy controls and patients with chronic hepatitis B (CHB), hepatitis B virus (HBV)-related liver cirrhosis, and HBV-related hepatocellular carcinoma (HCC). DESIGN AND METHODS: The study enrolled 300 individuals (50 healthy controls, 50 with CHB, 100 with HBV-associated cirrhosis, and 100 with HBV-associated HCC). Serum ITIH4 levels were determined by western blot analysis and expressed in densitometry units (DU). RESULTS: ITIH4 levels were higher in CHB (mean: 252.96 DU) and liver cirrhosis (mean: 206.43 DU) patients than in healthy controls (mean: 75.92 DU) and HCC patients (mean: 92.86 DU) (P <0.001). The area under the receiver operating characteristic curve was 0.71 for the diagnosis of HCC in patients with HBV-related liver disease. Multivariate Cox regression analysis showed that large tumor size (>5 cm) was independently associated with overall survival (hazard ratio 5.894, 95% confidence interval 1.373–25.300, P = 0.017). A Kaplan-Meier survival analysis showed significantly worse survival among HCC patients with both low ITIH4 (<80 DU) and a large tumor size compared to that among other HCC patients (P <0.001), and among patients with high AFP (>200 ng/mL) and low ITIH4 compared to that among other HCC patients (P = 0.041). CONCLUSIONS: Serum ITIH4 levels are reduced in HCC patients compared to that in CHB and cirrhosis patients, and low serum ITIH4 levels are associated with shorter survival in HBVassociated HCC patients.","abstract_html":"OBJECTIVES: Inter-alpha-trypsin inhibitor heavy chain H4 (ITIH4) is associated with various diseases. We evaluated the diagnostic and prognostic significance of serum ITIH4 levels in healthy controls and patients with chronic hepatitis B (CHB), hepatitis B virus (HBV)-related liver cirrhosis, and HBV-related hepatocellular carcinoma (HCC). DESIGN AND METHODS: The study enrolled 300 individuals (50 healthy controls, 50 with CHB, 100 with HBV-associated cirrhosis, and 100 with HBV-associated HCC). Serum ITIH4 levels were determined by western blot analysis and expressed in densitometry units (DU). RESULTS: ITIH4 levels were higher in CHB (mean: 252.96 DU) and liver cirrhosis (mean: 206.43 DU) patients than in healthy controls (mean: 75.92 DU) and HCC patients (mean: 92.86 DU) (P &lt;0.001). The area under the receiver operating characteristic curve was 0.71 for the diagnosis of HCC in patients with HBV-related liver disease. Multivariate Cox regression analysis showed that large tumor size (&gt;5 cm) was independently associated with overall survival (hazard ratio 5.894, 95% confidence interval 1.373–25.300, P = 0.017). A Kaplan-Meier survival analysis showed significantly worse survival among HCC patients with both low ITIH4 (&lt;80 DU) and a large tumor size compared to that among other HCC patients (P &lt;0.001), and among patients with high AFP (&gt;200 ng/mL) and low ITIH4 compared to that among other HCC patients (P = 0.041). CONCLUSIONS: Serum ITIH4 levels are reduced in HCC patients compared to that in CHB and cirrhosis patients, and low serum ITIH4 levels are associated with shorter survival in HBVassociated HCC patients.","abstract_has_math":false,"creators":["노, 충균"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["정, 재연","대학원 의학과","107702"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2014,"date_issued":"2014-11-14T01:19:16Z","date_published":"2014-11-14T01:19:16Z","updated_at":"2026-07-24T00:51:47Z","subjects":["Inter-alpha-trypsin inhibitor heavy chain H4","hepatitis B","hepatocellular carcinoma","survival","diagnosis","B형간염","간암","예후","진단"],"languages":["en"],"rights":[],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000017916","000000017916"],"render_values":[{"text":"http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000017916","href":"http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000017916","code":true},{"text":"000000017916","href":null,"code":true}]}]},"links":{"outbound_url":"http://repository.ajou.ac.kr/handle/201003/10923","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["정, 재연","대학원 의학과","107702","노, 충균"]},{"key":"dc:creator","label":"Author","values":["노, 충균"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2014-11-14T01:19:16Z","2014"]},{"key":"dc:type","label":"Dc Type","values":["Thesis","Theses"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Inter-alpha-trypsin inhibitor heavy chain H4","hepatitis B","hepatocellular carcinoma","survival","diagnosis","B형간염","간암","예후","진단"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["en"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["http://repository.ajou.ac.kr/handle/201003/10923","http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000017916","000000017916"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["OBJECTIVES: Inter-alpha-trypsin inhibitor heavy chain H4 (ITIH4) is associated with various diseases. We evaluated the diagnostic and prognostic significance of serum ITIH4 levels in healthy controls and patients with chronic hepatitis B (CHB), hepatitis B virus (HBV)-related liver cirrhosis, and HBV-related hepatocellular carcinoma (HCC). DESIGN AND METHODS: The study enrolled 300 individuals (50 healthy controls, 50 with CHB, 100 with HBV-associated cirrhosis, and 100 with HBV-associated HCC). Serum ITIH4 levels were determined by western blot analysis and expressed in densitometry units (DU). RESULTS: ITIH4 levels were higher in CHB (mean: 252.96 DU) and liver cirrhosis (mean: 206.43 DU) patients than in healthy controls (mean: 75.92 DU) and HCC patients (mean: 92.86 DU) (P <0.001). The area under the receiver operating characteristic curve was 0.71 for the diagnosis of HCC in patients with HBV-related liver disease. Multivariate Cox regression analysis showed that large tumor size (>5 cm) was independently associated with overall survival (hazard ratio 5.894, 95% confidence interval 1.373–25.300, P = 0.017). A Kaplan-Meier survival analysis showed significantly worse survival among HCC patients with both low ITIH4 (<80 DU) and a large tumor size compared to that among other HCC patients (P <0.001), and among patients with high AFP (>200 ng/mL) and low ITIH4 compared to that among other HCC patients (P = 0.041). CONCLUSIONS: Serum ITIH4 levels are reduced in HCC patients compared to that in CHB and cirrhosis patients, and low serum ITIH4 levels are associated with shorter survival in HBVassociated HCC patients.","목적: Inter-alpha-trypsin inhibitor heavy chain H4 (ITIH4)은 다양한 질환들과 관련이 있다. 본 연구에서는 정상 대조 군과 만성 B 형간염, B 형간염 연관 간 경변 증, B 형간염 연관 간암 환자들에서 ITIH4 의 진단적, 예후예측 인자로서의 중요성을 평가하였다. 방법: 300 명의 환자들을 대상으로 연구를 진행하였다 (50 명의 정상 대조군, 50 명의 만성 B 형간염, 100 명의 B 형간염 연관 간 경변 증, 100 명의 B 형간염 연관 간암). 혈청 ITIH4 값을 Western blot 분석으로 결정하였고, densitometry units(DU) 으로 나타내었다. 결과: ITIH4 는 만성 B 형간염 (평균: 252.96 DU)과 간 경변 증 (평균: 206.43 DU)에서 정상 대조군 (평균: 75.92 DU), 간암 환자군 (평균: 92.86 DU) 보다 더 높게 나타났다 (P<0.001). B 형간염 연관 간 질환 환자에서 간암 진단을 위한 AUROC 값은 0.71 이었다. 다변량 Cox 회귀 분석을 통해 큰 종양 크기 (>5 cm)가 독립적으로 생존율에 연관이 있음을 확인하였다 (위험도 5.894, 95% 신뢰구간 1.373–25.300, P = 0.017). Kaplan-Meier 생존 분석을 진행 하였을 때, 낮은 ITIH4 값 (<80 DU)과 큰 종양크기 (>5 cm)를 모두 충족시키는 환자들이 그렇지 않은 환자들 보다 유의하게 낮은 생존율을 보였다. 그리고, 높은 AFP 값 (>200 ng/mL)과, 낮은 ITIH4 값 (<80 DU)을 모두 충족 시키는 환자들이 그렇지 않은 환자들보다 낮은 생존율을 보였다 (P = 0.041). 결론: 혈청 ITIH4 값은 만성 B 형간염, 간 경변 증 환자들과 비교하여 간암 환자들에서 감소하는 결과를 보였고, 낮은 혈청 ITIH4 값은 B 형 간염 연관 간암 환자들에서 나쁜 생존율과 관련이 있음을 확인 하였다.","ABSTRACT ⅰ TABLE OF CONTENTS iii LIST OF FIGURES iv LIST OF TABLES v Ⅰ. INTRODUCTION 1 Ⅱ. PATIENTS AND METHODS 3 A. Patients and serum samples 3 B. Western blot analysis 3 C. Statistical analysis 4 Ⅲ. RESULTS 5 A. Selection of candidate biomarker for HBV-associated HCC 5 B. Diagnostic value of ITIH4 for the detection of HCC 6 C. Identification of factors that predict survival in patients with HCC 7 D. Prognostic significance of ITIH4 in patients with HCC 8 Ⅳ. DISCUSSION 13 Ⅴ. CONCLUSION 16 REFERENCES 17 국문요약 20","Master"]},{"key":"dc:title","label":"Title","values":["Inter-alpha-trypsin inhibitor heavy chain H4 as a diagnostic and prognostic indicator in patients with hepatitis B virus-associated hepatocellular carcinoma","B형 간염 관련 간암 환자에서 진단 및 예후 예측 인자로서 Inter-alpha-trypsin inhibitor heavy chain H4에 대한 연구"]}]}],"canonical_facts":{"dc:contributor":["정, 재연","대학원 의학과","107702","노, 충균"],"dc:creator":["노, 충균"],"dc:date":["2014-11-14T01:19:16Z","2014"],"dc:description":["OBJECTIVES: Inter-alpha-trypsin inhibitor heavy chain H4 (ITIH4) is associated with various diseases. We evaluated the diagnostic and prognostic significance of serum ITIH4 levels in healthy controls and patients with chronic hepatitis B (CHB), hepatitis B virus (HBV)-related liver cirrhosis, and HBV-related hepatocellular carcinoma (HCC). DESIGN AND METHODS: The study enrolled 300 individuals (50 healthy controls, 50 with CHB, 100 with HBV-associated cirrhosis, and 100 with HBV-associated HCC). Serum ITIH4 levels were determined by western blot analysis and expressed in densitometry units (DU). RESULTS: ITIH4 levels were higher in CHB (mean: 252.96 DU) and liver cirrhosis (mean: 206.43 DU) patients than in healthy controls (mean: 75.92 DU) and HCC patients (mean: 92.86 DU) (P <0.001). The area under the receiver operating characteristic curve was 0.71 for the diagnosis of HCC in patients with HBV-related liver disease. Multivariate Cox regression analysis showed that large tumor size (>5 cm) was independently associated with overall survival (hazard ratio 5.894, 95% confidence interval 1.373–25.300, P = 0.017). A Kaplan-Meier survival analysis showed significantly worse survival among HCC patients with both low ITIH4 (<80 DU) and a large tumor size compared to that among other HCC patients (P <0.001), and among patients with high AFP (>200 ng/mL) and low ITIH4 compared to that among other HCC patients (P = 0.041). CONCLUSIONS: Serum ITIH4 levels are reduced in HCC patients compared to that in CHB and cirrhosis patients, and low serum ITIH4 levels are associated with shorter survival in HBVassociated HCC patients.","목적: Inter-alpha-trypsin inhibitor heavy chain H4 (ITIH4)은 다양한 질환들과 관련이 있다. 본 연구에서는 정상 대조 군과 만성 B 형간염, B 형간염 연관 간 경변 증, B 형간염 연관 간암 환자들에서 ITIH4 의 진단적, 예후예측 인자로서의 중요성을 평가하였다. 방법: 300 명의 환자들을 대상으로 연구를 진행하였다 (50 명의 정상 대조군, 50 명의 만성 B 형간염, 100 명의 B 형간염 연관 간 경변 증, 100 명의 B 형간염 연관 간암). 혈청 ITIH4 값을 Western blot 분석으로 결정하였고, densitometry units(DU) 으로 나타내었다. 결과: ITIH4 는 만성 B 형간염 (평균: 252.96 DU)과 간 경변 증 (평균: 206.43 DU)에서 정상 대조군 (평균: 75.92 DU), 간암 환자군 (평균: 92.86 DU) 보다 더 높게 나타났다 (P<0.001). B 형간염 연관 간 질환 환자에서 간암 진단을 위한 AUROC 값은 0.71 이었다. 다변량 Cox 회귀 분석을 통해 큰 종양 크기 (>5 cm)가 독립적으로 생존율에 연관이 있음을 확인하였다 (위험도 5.894, 95% 신뢰구간 1.373–25.300, P = 0.017). Kaplan-Meier 생존 분석을 진행 하였을 때, 낮은 ITIH4 값 (<80 DU)과 큰 종양크기 (>5 cm)를 모두 충족시키는 환자들이 그렇지 않은 환자들 보다 유의하게 낮은 생존율을 보였다. 그리고, 높은 AFP 값 (>200 ng/mL)과, 낮은 ITIH4 값 (<80 DU)을 모두 충족 시키는 환자들이 그렇지 않은 환자들보다 낮은 생존율을 보였다 (P = 0.041). 결론: 혈청 ITIH4 값은 만성 B 형간염, 간 경변 증 환자들과 비교하여 간암 환자들에서 감소하는 결과를 보였고, 낮은 혈청 ITIH4 값은 B 형 간염 연관 간암 환자들에서 나쁜 생존율과 관련이 있음을 확인 하였다.","ABSTRACT ⅰ TABLE OF CONTENTS iii LIST OF FIGURES iv LIST OF TABLES v Ⅰ. INTRODUCTION 1 Ⅱ. PATIENTS AND METHODS 3 A. Patients and serum samples 3 B. Western blot analysis 3 C. Statistical analysis 4 Ⅲ. RESULTS 5 A. Selection of candidate biomarker for HBV-associated HCC 5 B. Diagnostic value of ITIH4 for the detection of HCC 6 C. Identification of factors that predict survival in patients with HCC 7 D. Prognostic significance of ITIH4 in patients with HCC 8 Ⅳ. DISCUSSION 13 Ⅴ. CONCLUSION 16 REFERENCES 17 국문요약 20","Master"],"dc:identifier":["http://repository.ajou.ac.kr/handle/201003/10923","http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000017916","000000017916"],"dc:language":["en"],"dc:subject":["Inter-alpha-trypsin inhibitor heavy chain H4","hepatitis B","hepatocellular carcinoma","survival","diagnosis","B형간염","간암","예후","진단"],"dc:title":["Inter-alpha-trypsin inhibitor heavy chain H4 as a diagnostic and prognostic indicator in patients with hepatitis B virus-associated hepatocellular carcinoma","B형 간염 관련 간암 환자에서 진단 및 예후 예측 인자로서 Inter-alpha-trypsin inhibitor heavy chain H4에 대한 연구"],"dc:type":["Thesis","Theses"]},"updated_at":"2026-07-24T00:51:47Z"}