Tamaki Nobuharu, Kurosaki Masayuki, Kuno Atsushi, Korenaga Masaaki, Togayachi Akira, Gotoh Masanori, Nakakuki Natsuko, Takada Hitomi, Matsuda Shuya, Hattori Nobuhiro, Yasui Yutaka, Suzuki Shoko, Hosokawa Takanori, Tsuchiya Kaoru, Nakanishi Hiroyuki, Itakura Jun, Takahashi Yuka, Mizokami Masashi, Narimatsu Hisashi, Izumi Namiki
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.
Research Center for Medical Glycoscience, National Institute of Advanced Industrial Science and Technology, Ibaraki, Japan.
Hepatol Res. 2015 Oct;45(10):E82-8. doi: 10.1111/hepr.12466. Epub 2015 Jan 28.
Wisteria floribunda agglutinin (WFA)-positive human Mac-2-binding protein (WFA(+) -M2BP) is a new glycol marker related to liver fibrosis. The aim of the present study was to evaluate WFA(+) -M2BP as a predictor of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C.
This case-control study included 14 patients with chronic hepatitis C who developed HCC and 52controls, matched for age, gender, and fibrosis stage. WFA(+) -M2BP was measured at biopsy and follow-up. Time zero was set at the date of liver biopsy.
WFA(+) -M2BP increased stepwise with progression of liver fibrosis (p < 0.001). Cumulative incidence of HCC development was significantly higher in patients with WFA(+) -M2BP ≥4.2 (p < 0.001) or in those with time-course changes in WFA(+) -M2BP (ΔWFA(+) -M2BP/year) ≥0.3 (p = 0.03). Multivariate analyses demonstrated that WFA(+) -M2BP ≥4.2 [hazard ratio (HR): 4.1, 95% confidence interval (CI): 1.1-15, p = 0.04], ΔWFA(+) -M2BP/year ≥0.3 (HR: 5.5, 95% CI: 1.5-19, p = 0.008), and AFP ≥10 ng/ml (HR: 4.7, 95% CI: 1.1-19, p = 0.03) were independent predictive factors of HCC development. Based on these data, we developed a simple scoring system to predict HCC development using these three factors. Using these scores, patients were classified into four groups; cumulative incidence of HCC development significantly increased with increasing scores (p < 0.001).
WFA(+) -M2BP measurements and time-course changes in WFA(+) -M2BP can be used to identify patients at high risk of HCC development. Real-time monitoring of WFA(+) -M2BP can be a novel predictor of HCC development.
紫藤凝集素（WFA）阳性的人Mac-2结合蛋白（WFA(+) -M2BP）是一种与肝纤维化相关的新型糖标记物。本研究旨在评估WFA(+) -M2BP作为慢性丙型肝炎患者肝细胞癌（HCC）发生的预测指标。
本病例对照研究纳入了14例发生HCC的慢性丙型肝炎患者和52例年龄、性别及纤维化分期相匹配的对照。在活检及随访时检测WFA(+) -M2BP。时间零点设定为肝活检日期。
WFA(+) -M2BP随肝纤维化进展呈逐步升高（p < 0.001）。WFA(+) -M2BP≥4.2的患者（p < 0.001）或WFA(+) -M2BP有时间进程变化（ΔWFA(+) -M2BP/年）≥0.3的患者（p = 0.03）中HCC发生的累积发生率显著更高。多因素分析表明，WFA(+) -M2BP≥4.2 [风险比（HR）：4.1，95%置信区间（CI）：1.1 - 15，p = 0.04]、ΔWFA(+) -M2BP/年≥0.3（HR：5.5，95% CI：1.5 - 19，p = 0.008）以及甲胎蛋白（AFP）≥10 ng/ml（HR：4.7，95% CI：1.1 - 19，p = 0.03）是HCC发生的独立预测因素。基于这些数据，我们使用这三个因素开发了一个简单的评分系统来预测HCC发生。根据这些评分，将患者分为四组；HCC发生的累积发生率随评分增加而显著升高（p < 0.001）。
WFA(+) -M2BP检测及WFA(+) -M2BP的时间进程变化可用于识别HCC发生的高危患者。对WFA(+) -M2BP进行实时监测可能是HCC发生的一种新型预测指标。
