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血清槐凝集素阳性 Mac-2 结合蛋白评估肝功能并预测肝硬化预后。

Serum Wisteria floribunda agglutinin-positive Mac-2-binding protein evaluates liver function and predicts prognosis in liver cirrhosis.

机构信息

Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China.

Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

J Dig Dis. 2018 Apr;19(4):242-253. doi: 10.1111/1751-2980.12596.

Abstract

OBJECTIVE

Wisteria floribunda agglutinin-positive Mac-2-binding protein (WFA -M2BP) is a novel glycobiomarker for evaluating liver fibrosis, but less is known about its role in liver cirrhosis (LC). This study aimed to investigate the utility of WFA -M2BP in evaluating liver function and predicting prognosis of cirrhotic patients.

METHODS

We retrospectively included 197 patients with LC between 2013 and 2016. Serum WFA -M2BP and various biochemical parameters were measured in all patients. With a median follow-up of 23 months, liver-related complications and deaths of 160 patients were recorded. The accuracy of WFA -M2BP in evaluating liver function, predicting decompensation and mortality were measured by the receiver operating characteristic (ROC) curve, logistic and Cox's regression analyses, respectively.

RESULTS

WFA -M2BP levels increased with elevated Child-Pugh classification, especially in patients with hepatitis B virus (HBV) infection. ROC analysis confirmed the high reliability of WFA -M2BP for the assessment of liver function using Child-Pugh classification. WFA -M2BP was also significantly positively correlated with the model for end-stage liver disease (MELD) score. Multivariate logistic regression analysis indicated WFA -M2BP as an independent predictor of clinical decompensation for compensated patients (odds ratio 11.958, 95% confidence interval [CI] 1.876-76.226, P = 0.009), and multivariate Cox's regression analysis verified WFA -M2BP as an independent risk factor for liver-related death in patients with HBV infection (hazards ratio 10.596, 95% CI 1.356-82.820, P = 0.024).

CONCLUSION

Serum WFA -M2BP is a reliable predictor of liver function and prognosis in LC and could be incorporated into clinical surveillance strategies for LC patients, especially those with HBV infection.

摘要

目的

槐凝集素阳性 Mac-2 结合蛋白(WFA-M2BP)是一种新型糖生物标志物,可用于评估肝纤维化,但关于其在肝硬化(LC)中的作用知之甚少。本研究旨在探讨 WFA-M2BP 在评估肝功能和预测肝硬化患者预后中的应用价值。

方法

我们回顾性纳入了 2013 年至 2016 年间的 197 例 LC 患者。所有患者均检测血清 WFA-M2BP 和各种生化参数。中位随访 23 个月后,记录了 160 例患者的肝脏相关并发症和死亡情况。采用受试者工作特征(ROC)曲线、Logistic 和 Cox 回归分析分别评估 WFA-M2BP 评估肝功能、预测失代偿和死亡率的准确性。

结果

WFA-M2BP 水平随 Child-Pugh 分级的升高而升高,尤其是乙型肝炎病毒(HBV)感染者。ROC 分析证实 WFA-M2BP 对基于 Child-Pugh 分级的肝功能评估具有较高的可靠性。WFA-M2BP 与终末期肝病模型(MELD)评分也呈显著正相关。多变量 Logistic 回归分析表明,WFA-M2BP 是代偿期患者临床失代偿的独立预测因子(比值比 11.958,95%置信区间 [CI] 1.876-76.226,P=0.009),多变量 Cox 回归分析证实 WFA-M2BP 是 HBV 感染者肝脏相关死亡的独立危险因素(危险比 10.596,95%CI 1.356-82.820,P=0.024)。

结论

血清 WFA-M2BP 是 LC 患者肝功能和预后的可靠预测指标,可纳入 LC 患者的临床监测策略,特别是 HBV 感染者。

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