Department of Laboratory Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Laboratory for Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ann Lab Med. 2018 Jul;38(4):348-354. doi: 10.3343/alm.2018.38.4.348.
Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA-M2BP) is a protein with altered glycosylation that reacts with lectin, and was recently identified as a useful non-invasive biomarker for the diagnosis of liver fibrosis in patients with hepatitis C virus infection.This study aimed to evaluate the diagnostic efficacy of WFA-M2BP for liver fibrosis in the context of hepatitis B virus (HBV).
We enrolled 151 patients infected with HBV. Liver biopsy and elastography (Fibroscan) were performed during the initial visit. Fibrosis was graded according to the Knodell histologic activity index (F0-3). WFA-M2BP levels were determined with an automated immunoassay analyzer (M2BPGi, HISCL-5000, Sysmex, Japan). The diagnostic efficacy of WFA-M2BP was compared with those of various conventional or composite biomarkers, including enhanced liver fibrosis (ELF) score, Fibroscan, aspartate transaminase (AST)-to-platelet ratio index (APRI), and FIB-4, based on the area under the ROC curve (AUC) value.
The majority of patients were at fibrosis stages F1 and F2. The F2 and F3 AUC values for WFA-M2BP were similar to those for FIB-4, APRI, ELF, and Fibroscan, although the latter showed the best diagnostic efficacy. The diagnostic accuracy of all tested biomarkers for F2 and F3 was 60-70%. In multivariate analysis, WFA-M2BP, ELF, and platelet count significantly predicted stage ≥F2, whereas only platelet count significantly predicted F3.
WFA-M2BP can support a diagnosis of liver fibrosis with similar diagnostic efficacy to other biomarkers, and predicted liver fibrosis stage ≥2 among patients with chronic hepatitis B.
槐凝集素阳性 Mac-2 结合蛋白（WFA-M2BP）是一种糖基化改变的蛋白，与凝集素反应，最近被鉴定为丙型肝炎病毒感染患者肝纤维化诊断的有用的非侵入性生物标志物。本研究旨在评估 WFA-M2BP 在乙型肝炎病毒（HBV）背景下对肝纤维化的诊断效能。
我们纳入了 151 例 HBV 感染患者。在初次就诊时进行肝活检和弹性成像（Fibroscan）。根据 Knodell 组织学活动指数（F0-3）对纤维化进行分级。使用自动化免疫分析仪（M2BPGi，HISCL-5000，Sysmex，日本）测定 WFA-M2BP 水平。根据 ROC 曲线下面积（AUC）值，将 WFA-M2BP 的诊断效能与各种常规或组合生物标志物（包括增强型纤维化（ELF）评分、Fibroscan、天冬氨酸转氨酶（AST）与血小板比值指数（APRI）和 FIB-4）进行比较。
大多数患者处于纤维化分期 F1 和 F2。WFA-M2BP 的 F2 和 F3 AUC 值与 FIB-4、APRI、ELF 和 Fibroscan 相似，但后者的诊断效果最佳。所有测试生物标志物对 F2 和 F3 的诊断准确性均为 60-70%。在多变量分析中，WFA-M2BP、ELF 和血小板计数显著预测≥F2 期，而仅血小板计数显著预测 F3 期。
WFA-M2BP 可支持肝纤维化的诊断，其诊断效能与其他生物标志物相似，并可预测慢性乙型肝炎患者的肝纤维化≥2 期。
