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