Abstract: Objective To investigate the clinical value of T cell immunoglobulin mucin 3 (Tim-3) combined with gamma-glutamyl transpeptidase to cholinesterase ratio (GCR) in chronic hepatitis B (CHB) patients with normal or slightly elevated transaminase.Methods The clinical data of 109 CHB patients with normal or slightly elevated transaminase were retrospectively analyzed. The receiver operating characteristic (ROC) curve was used to analyze the value of serum Tim-3 and GCR in evaluating the liver inflammation stage and liver fibrosis grade of CHB patients with normal or slightly elevated transaminase.Results Among 109 CHB patients, the numbers of inflammation stages 1, 2, 3 and 4 were 40, 30, 26 and 13; the numbers of fibrosis stages 1, 2, 3, and 4 were 44, 32, 20 and 13. The serum Tim-3 level and GCR in CHB patients with different liver inflammation stages were significantly different (F=24.581, P=0.002; F=12.495, P=0.013). The serum Tim-3 level and GCR of patients in G2 [(16.09±3.57) ng/L, (1.04±0.29)] were higher than those of patients in G1 [(14.28±2.43) ng/L, (0.86±0.17)] and lower than those of patients in G3 [(18.65±4.81) ng/L, (1.26±0.38) ng/L], (P<0.05). The serum Tim-3 level and GCR of patients in G4 [(21.14±5.92) ng/L, (1.41±0.47) ng/L] were higher than those of patients in G3 [(18.65±4.81) ng/L, (1.26±0.38) ng/L], (P<0.05). ROC curve analysis showed that both Tim-3 and GCR could predict liver inflammation stages. The area under the curve (AUC) of Tim-3 combined with GCR was the largest (P<0.05). The serum Tim-3 level and GCR of CHB patients with different liver fibrosis stages were significantly different (F=22.165, P=0.008; F=11.388, P=0.018). The serum Tim-3 level and GCR of patients in S2 were higher than those of patients in S1 (P<0.05) and lower than those of patients in S3 (P<0.05). The serum Tim-3 level and GCR of patients in S4 were higher than those of patients in S3 (P<0.05). ROC curve analysis showed that both Tim-3 and GCR can predict liver fibrosis stages (P<0.05). The AUC of Tim-3 combined with GCR was the largest (P<0.05).Conclusion Both Tim-3 and GCR can predict liver inflammation and fibrosis stages of CHB patients with normal or slightly elevated transaminase. Tim-3 combined with GCR has the highest diagnosing value.

Key words: Chronic hepatitis B, Normal or slightly elevated transaminase, T cell immunoglobulin mucin 3, Gamma-glutamyl transpeptidase, Cholinesterase, Liver inflammation, Liver fibrosis