Ito Kiyoaki, Murotani Kenta, Nakade Yukiomi, Inoue Tadahisa, Nakao Haruhisa, Sumida Yoshio, Kamada Yoshihiro, Yoneda Masashi
Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
Division of Biostatistics, Clinical Research Center, Aichi Medical University School of Medicine, Nagakute, Japan.
J Gastroenterol Hepatol. 2017 Dec;32(12):1922-1930. doi: 10.1111/jgh.13802.
A reliable, non-invasive biomarker for diagnosis of liver fibrosis in chronic liver disease patients is needed. The aim of this study was to assess by meta-analysis the efficacy of measuring serum levels of Wisteria floribunda agglutinin-positive Mac-2-binding protein (WFA -M2BP), a novel and promising biomarker, for staging liver fibrosis and predicting the development of hepatocellular carcinoma and overall survival.
We performed a meta-analysis using online journal database searches. We identified 39 studies, 21 of which met the criteria for meta-analysis. Sensitivity and specificity of WFA -M2BP for assessing liver fibrosis staging in chronic liver diseases with broad etiologies were determined. Hazard ratios with 95% confidence intervals were also used for predicting hepatocellular carcinoma development and overall survival.
With WFA -M2BP, the sensitivity and specificity for predicting significant fibrosis (≥ F2), advanced fibrosis (≥ F3), and liver cirrhosis (= F4) were 0.690 and 0.778, 0.764 and 0.758, and 0.818 and 0.839, respectively. Sensitivity and specificity for diagnosing liver fibrosis in patients with hepatitis C virus were mostly higher than those in overall patients. However, sensitivity and specificity for diagnosing liver fibrosis in patients with hepatitis B virus were lower than those in overall patients. Overall, hazard ratios for development of hepatocellular carcinoma and overall survival were 5.946 and 1.068, respectively.
These results suggest that serum WFA -M2BP is a reliable predictor for liver fibrosis staging and a good substitute for liver biopsy. It is also useful for predicting both hepatocellular carcinoma development and overall survival.
慢性肝病患者需要一种可靠的、非侵入性的生物标志物来诊断肝纤维化。本研究的目的是通过荟萃分析评估检测血清紫藤凝集素阳性Mac-2结合蛋白（WFA-M2BP）水平的效果，WFA-M2BP是一种新型且有前景的生物标志物，用于肝纤维化分期以及预测肝细胞癌的发生和总生存期。
我们通过在线期刊数据库检索进行荟萃分析。我们识别出39项研究，其中21项符合荟萃分析标准。确定了WFA-M2BP在评估病因广泛的慢性肝病肝纤维化分期方面的敏感性和特异性。还使用95%置信区间的风险比来预测肝细胞癌的发生和总生存期。
对于WFA-M2BP，预测显著纤维化（≥F2）、进展性纤维化（≥F3）和肝硬化（=F4）的敏感性和特异性分别为0.690和0.778、0.764和0.758、0.818和0.839。丙型肝炎病毒患者诊断肝纤维化的敏感性和特异性大多高于总体患者。然而，乙型肝炎病毒患者诊断肝纤维化的敏感性和特异性低于总体患者。总体而言，肝细胞癌发生和总生存期的风险比分别为5.946和1.068。
这些结果表明，血清WFA-M2BP是肝纤维化分期的可靠预测指标，是肝活检的良好替代方法。它在预测肝细胞癌发生和总生存期方面也很有用。
