Chuaypen Natthaya, Chittmittraprap Salyavit, Pinjaroen Nutcha, Sirichindakul Boonchoo, Poovorawan Yong, Tanaka Yasuhito, Tangkijvanich Pisit
Center of Excellence in Hepatitis and Liver Cancer, Chulalongkorn University, Bangkok, Thailand.
Department of Radiology, Chulalongkorn University, Bangkok, Thailand.
Hepatol Res. 2018 Oct;48(11):872-881. doi: 10.1111/hepr.13187. Epub 2018 Jun 3.
Serum glycosylated Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA -M2BP) is a novel marker for staging liver fibrosis and predicting hepatocellular carcinoma (HCC) occurrence. This study aimed at evaluating the performance of WFA -M2BP in the diagnosis of HCC in patients with chronic hepatitis B virus (HBV) infection.
The WFA -M2BP levels were measured in stored samples collected at initial diagnosis of 150 patients with HBV-related HCC and 150 age- and gender-matched patients with non-malignant chronic HBV infection.
Patients with HCC had higher levels of WFA -M2BP than those without HCC (3.9 [1.5-20.6] vs. 1.6 [0.4-9.3] cut-off index [COI], P < 0.001). In the HCC group, WFA -M2BP levels correlated with Child-Pugh classification but did not correlate with HBV markers, α-fetoprotein (AFP), or Barcelona Clinic Liver Cancer (BCLC) stage. The areas under the curve (AUROC) for differentiating HCC from non-HCC were 0.92 (95% confidence interval [CI], 0.89-0.95; P < 0.001) for WFA -M2BP, 0.90 (95% CI, 0.87-0.94; P < 0.001) for AFP, and 0.97 (95% CI, 0.95-0.98; P < 0.001) for the combination of both markers. At the optimal cut-off (2.4 COI), WFA -M2BP had sensitivity, specificity, and accuracy of 79.3%, 91.3%, and 85.3%, respectively. The WFA -M2BP marker was superior to AFP in differentiating early-stage HCC (BCLC stages 0 and A) from cirrhosis with AUROC of 0.80 (95% CI, 0.68-0.91; P < 0.001) and 0.73 (95% CI, 0.60-0.86; P = 0.002), respectively. By univariate analysis, elevated WFA -M2BP (≥4.0 COI) was correlated with poor overall survival in patients with HCC.
Wisteria floribunda agglutinin-positive M2BP showed a better diagnostic performance than AFP in detecting early-stage HCC. Thus, WFA -M2BP level could represent a promising marker for early diagnosis of HCC in patients with chronic HBV infection.
血清糖基化紫藤凝集素阳性Mac-2结合蛋白（WFA-M2BP）是肝纤维化分期及预测肝细胞癌（HCC）发生的新型标志物。本研究旨在评估WFA-M2BP在慢性乙型肝炎病毒（HBV）感染患者HCC诊断中的性能。
检测150例HBV相关HCC患者初诊时采集的储存样本以及150例年龄和性别匹配的非恶性慢性HBV感染患者的WFA-M2BP水平。
HCC患者的WFA-M2BP水平高于无HCC患者（截断指数[COI]：3.9[1.5 - 20.6]对1.6[0.4 - 9.3]，P<0.001）。在HCC组中，WFA-M2BP水平与Child-Pugh分级相关，但与HBV标志物、甲胎蛋白（AFP）或巴塞罗那临床肝癌（BCLC）分期无关。区分HCC与非HCC的曲线下面积（AUROC）：WFA-M2BP为0.92（95%置信区间[CI]，0.89 - 0.95；P<0.001），AFP为0.90（95%CI，0.87 - 0.94；P<0.001），两种标志物联合为0.97（95%CI，0.95 - 0.98；P<0.001）。在最佳截断值（2.4 COI）时，WFA-M2BP的敏感性、特异性和准确性分别为79.3%、91.3%和85.3%。在区分早期HCC（BCLC 0期和A期）与肝硬化方面，WFA-M2BP标志物优于AFP，其AUROC分别为0.80（95%CI，0.68 - 0.91；P<0.001）和0.73（95%CI，0.60 - 0.86；P = 0.002）。单因素分析显示，WFA-M2BP升高（≥4.0 COI）与HCC患者较差的总生存期相关。
紫藤凝集素阳性M2BP在检测早期HCC方面表现出比AFP更好的诊断性能。因此，WFA-M2BP水平可能是慢性HBV感染患者HCC早期诊断的有前景的标志物。
