Hasegawa Kunihiro, Takata Ryo, Nishikawa Hiroki, Enomoto Hirayuki, Ishii Akio, Iwata Yoshinori, Miyamoto Yuho, Ishii Noriko, Yuri Yukihisa, Nakano Chikage, Nishimura Takashi, Yoh Kazunori, Aizawa Nobuhiro, Sakai Yoshiyuki, Ikeda Naoto, Takashima Tomoyuki, Iijima Hiroko, Nishiguchi Shuhei
Division of Hepatobiliary and Pancreatic disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo 663-8501, Japan.
Int J Mol Sci. 2016 Sep 12;17(9):1500. doi: 10.3390/ijms17091500.
We aimed to examine the effect of Wisteria floribunda agglutinin-positive Mac-2-binding protein (WFA⁺-M2BP) level on survival comparing with other laboratory liver fibrosis markers in hepatitis C virus (HCV)-related compensated liver cirrhosis (LC) (n = 165). For assessing prognostic performance of continuous fibrosis markers, we adapted time-dependent receiver operating characteristics (ROC) curves for clinical outcome. In time-dependent ROC analysis, annual area under the ROCs (AUROCs) were plotted. We also calculated the total sum of AUROCs in all time-points (TAAT score) in each fibrosis marker. WFA⁺-M2BP value ranged from 0.66 cutoff index (COI) to 19.95 COI (median value, 5.29 COI). Using ROC analysis for survival, the optimal cutoff point for WFA⁺-M2BP was 6.15 COI (AUROC = 0.79348, sensitivity = 80.0%, specificity = 74.78%). The cumulative five-year survival rate in patients with WFA⁺-M2BP ≥ 6.15 COI (n = 69) was 43.99%, while that in patients with WFA⁺-M2BP < 6.15 COI (n = 96) was 88.40% (p < 0.0001). In the multivariate analysis, absence of hepatocellular carcinoma (p = 0.0008), WFA⁺-M2BP < 6.15 COI (p = 0.0132), achievement of sustained virological response (p < 0.0001) and des-γ-carboxy prothrombin < 41 mAU/mL (p = 0.0018) were significant favorable predictors linked to survival. In time-dependent ROC analysis in all cases, WFA⁺-M2BP had the highest TAAT score among liver fibrosis markers. In conclusion, WFA⁺-M2BP can be a useful predictor in HCV-related compensated LC.
我们旨在研究紫藤凝集素阳性Mac-2结合蛋白(WFA⁺-M2BP)水平对丙型肝炎病毒(HCV)相关代偿期肝硬化(LC)(n = 165)患者生存的影响,并与其他实验室肝纤维化标志物进行比较。为评估连续纤维化标志物的预后性能,我们采用了针对临床结局的时间依赖性受试者工作特征(ROC)曲线。在时间依赖性ROC分析中,绘制了每年的ROC曲线下面积(AUROC)。我们还计算了每个纤维化标志物在所有时间点的AUROC总和(TAAT评分)。WFA⁺-M2BP值范围为0.66临界指数(COI)至19.95 COI(中位数为5.29 COI)。通过生存的ROC分析,WFA⁺-M2BP的最佳临界值为6.15 COI(AUROC = 0.79348,灵敏度 = 80.0%,特异性 = 74.78%)。WFA⁺-M2BP≥6.15 COI的患者(n = 69)的累积五年生存率为43.99%,而WFA⁺-M2BP<6.15 COI的患者(n = 96)的累积五年生存率为88.40%(p < 0.0001)。在多变量分析中,无肝细胞癌(p = 0.0008)、WFA⁺-M2BP<6.15 COI(p = 0.0132)、实现持续病毒学应答(p < 0.0001)以及去γ-羧基凝血酶原<41 mAU/mL(p = 0.0018)是与生存相关的显著有利预测因素。在所有病例的时间依赖性ROC分析中,WFA⁺-M2BP在肝纤维化标志物中具有最高的TAAT评分。总之,WFA⁺-M2BP可作为HCV相关代偿期LC的有用预测指标。