Nagata Hiroko, Nakagawa Mina, Nishimura-Sakurai Yuki, Asano Yu, Tsunoda Tomoyuki, Miyoshi Masato, Kaneko Shun, Goto Fumio, Otani Satoshi, Kawai-Kitahata Fukiko, Murakawa Miyako, Nitta Sayuri, Itsui Yasuhiro, Azuma Seishin, Kakinuma Sei, Tojo Naoko, Tohda Shuji, Asahina Yasuhiro, Watanabe Mamoru
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Institute of Education, Tokyo Medical and Dental University, Tokyo, Japan.
Hepatol Int. 2016 Nov;10(6):956-964. doi: 10.1007/s12072-016-9754-1. Epub 2016 Jul 19.
Wisteria floribunda agglutinin positive (WFA) Mac-2-binding protein (M2BPGi) is a noninvasive glyco-marker for liver fibrosis. This study evaluated the utility of serial measurement of serum M2BPGi and total M2BP as a predictor of fibrosis and the development of hepatocellular carcinoma (HCC).
This study included 119 patients with chronic hepatitis C (CHC). Of these patients, 97 were treated with IFN-based therapy and 22 were treated with daclatasvir and asunaprevir. Serum M2BPGi values were measured prior to, at the end of, and at 24 weeks after the completion of treatment. As subanalysis, serum total M2BP levels were measured in patients treated with pegylated-interferon and ribavirin.
In patients treated with IFN-based therapy, M2BPGi levels were elevated at the end of treatment but decreased afterwards. In contrast, M2BPGi levels in patients treated with IFN-free therapy decreased immediately after starting the treatment without transient elevation. Though pre-treatment M2BPGi levels significantly correlated with fibrosis in both patients with a sustained virological response (SVR) and non-SVR, post-treatment M2BPGi levels decreased regardless of the degree of fibrosis in patients with SVR. In multivariate analysis, non-SVR and HCC development were independent factors associated with M2BPGi level ≥2.2. In patients treated with pegylated-interferon and ribavirin, total M2BP levels were positively correlated with fibrosis and HCC development.
Real-time monitoring of the serum M2BPGi level after antiviral therapy for CHC patients could be a helpful screening tool for assessing the risk of HCC. M2BP and its glycan structure could be associated together with hepatocarcinogenesis.
紫藤凝集素阳性（WFA）Mac-2结合蛋白（M2BPGi）是一种用于肝纤维化的非侵入性糖标志物。本研究评估了连续检测血清M2BPGi和总M2BP作为纤维化及肝细胞癌（HCC）发生预测指标的效用。
本研究纳入119例慢性丙型肝炎（CHC）患者。其中，97例接受基于干扰素的治疗，22例接受daclatasvir和asunaprevir治疗。在治疗前、治疗结束时及治疗完成后24周检测血清M2BPGi值。作为亚分析，对接受聚乙二醇干扰素和利巴韦林治疗的患者检测血清总M2BP水平。
在接受基于干扰素治疗的患者中，M2BPGi水平在治疗结束时升高，但随后下降。相比之下，接受无干扰素治疗的患者在开始治疗后M2BPGi水平立即下降，无短暂升高。尽管在持续病毒学应答（SVR）和非SVR患者中，治疗前M2BPGi水平均与纤维化显著相关，但在SVR患者中，无论纤维化程度如何，治疗后M2BPGi水平均下降。多因素分析显示，非SVR和HCC发生是与M2BPGi水平≥2.2相关的独立因素。在接受聚乙二醇干扰素和利巴韦林治疗的患者中，总M2BP水平与纤维化及HCC发生呈正相关。
对CHC患者进行抗病毒治疗后实时监测血清M2BPGi水平可能是评估HCC风险的有用筛查工具。M2BP及其聚糖结构可能与肝癌发生相关。
