Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan,
J Gastroenterol. 2015 Jul;50(7):776-84. doi: 10.1007/s00535-014-1007-2. Epub 2014 Oct 18.
Accurately evaluating liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) is important for identifying those who may develop complications. The aims of this study were (1) to measure serum Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA(+)-M2BP) using the glycan sugar chain-based immunoassay and (2) to compare the results with clinical assessments of fibrosis.
Serum WFA(+)-M2BP values were retrospectively evaluated in 289 patients with NAFLD who had undergone liver biopsy. Histological findings were evaluated by three blinded, experienced liver-specific pathologists.
For stages 0 (n = 35), 1 (n = 113), 2 (n = 49), 3 (n = 41), and 4 (n = 51) of liver fibrosis, the serum WFA(+)-M2BP cutoff indexes were 0.57, 0.70, 1.02, 1.57, and 2.96, respectively. Multivariate regression analysis showed that serum WFA(+)-M2BP values were associated with the stage of fibrosis (≥stage 2). The areas under the receiver operating characteristic curve (AUROC), sensitivity, and specificity of serum WFA(+)-M2BP were 0.876, 85.9, and 74.6%, respectively, for severe fibrosis (≥stage 3) and were 0.879, 74.6, and 87.0%, respectively, for cirrhosis. When compared with six non-invasive conventional markers, serum WFA(+)-M2BP had the greatest AUROC for diagnosing severe fibrosis and cirrhosis.
Serum WFA(+)-M2BP values are useful for assessing the stage of liver fibrosis in patients with NAFLD.
准确评估非酒精性脂肪性肝病(NAFLD)患者的肝纤维化程度对于识别可能发生并发症的患者非常重要。本研究的目的是:(1)使用基于糖链的免疫测定法测量血清 Wisteria floribunda agglutinin-阳性 Mac-2 结合蛋白(WFA(+)-M2BP);(2)将结果与纤维化的临床评估进行比较。
回顾性评估了 289 例接受肝活检的 NAFLD 患者的血清 WFA(+)-M2BP 值。三位经验丰富的肝脏特异性病理学家对组织学发现进行了评估。
对于纤维化 0 期(n = 35)、1 期(n = 113)、2 期(n = 49)、3 期(n = 41)和 4 期(n = 51),血清 WFA(+)-M2BP 截断指数分别为 0.57、0.70、1.02、1.57 和 2.96。多变量回归分析表明,血清 WFA(+)-M2BP 值与纤维化分期(≥2 期)相关。血清 WFA(+)-M2BP 的受试者工作特征曲线(AUROC)下面积、敏感性和特异性对于严重纤维化(≥3 期)分别为 0.876、85.9 和 74.6%,对于肝硬化分别为 0.879、74.6 和 87.0%。与六项非侵入性常规标志物相比,血清 WFA(+)-M2BP 对诊断严重纤维化和肝硬化的 AUROC 最大。
血清 WFA(+)-M2BP 值可用于评估 NAFLD 患者的肝纤维化分期。