Ueno Takehisa, Kodama Tasuku, Noguchi Yuki, Saka Ryuta, Takama Yuichi, Tazuke Yuko, Bessho Kazuhiko, Okuyama Hiroomi
Department of Pediatric Surgery, Osaka University of Graduation School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Department of Pediatrics, Osaka University of Graduation School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Pediatr Surg Int. 2018 Oct;34(10):1065-1071. doi: 10.1007/s00383-018-4317-2. Epub 2018 Aug 20.
The Mac-2-binding protein glycosylation-modified isomer (M2BPGi) is a new marker for progression of hepatic fibrosis. We examined the relationship between serum M2BPGi levels and liver histological findings in patients with biliary atresia (BA) who were not transplant candidates.
Patients with BA who were not transplant candidates with good liver function were included. We examined M2BPGi levels and histological findings in relation to other laboratory markers of liver fibrosis, including aspartate aminotransferase (AST) to platelet ratio index, fibrosis-4 index, and type IV collagen 7s domain. Liver fibrosis was evaluated based on the METVIR score.
37 patients were included. The median age was 18 years (range 3-38 years). M2BPGi values ranged from 0.3 to 6.9 cutoff index (COI) (median 1.6). The degree of liver fibrosis varied with M2BPGi level. For predicting cirrhosis (F4) and advanced liver fibrosis (≥ F3), M2BPGi had higher areas under the curve (AUCs; 0.93, respectively) with cutoff COIs of 1.84 and 1.67, respectively, than for the four conventional markers for fibrosis.
M2BPGi is a novel marker for liver fibrosis in patients with BA. It is especially useful for following patients with BA with a native liver and supporting liver biopsy interpretation findings.
Mac-2结合蛋白糖基化修饰异构体（M2BPGi）是肝纤维化进展的一种新标志物。我们研究了非移植候选的胆道闭锁（BA）患者血清M2BPGi水平与肝脏组织学结果之间的关系。
纳入肝功能良好的非移植候选BA患者。我们研究了M2BPGi水平和组织学结果与肝纤维化的其他实验室标志物的关系，包括天冬氨酸转氨酶（AST）与血小板比值指数、纤维化-4指数和IV型胶原7s结构域。根据METVIR评分评估肝纤维化。
纳入37例患者。中位年龄为18岁（范围3 - 38岁）。M2BPGi值范围为0.3至6.9临界指数（COI）（中位数1.6）。肝纤维化程度随M2BPGi水平而变化。对于预测肝硬化（F4）和进展性肝纤维化（≥F3），M2BPGi的曲线下面积（AUC）更高（分别为0.93），临界COI分别为1.84和1.67，高于四种传统纤维化标志物。
M2BPGi是BA患者肝纤维化的一种新型标志物。它对于随访有自身肝脏的BA患者以及辅助肝活检解释结果特别有用。
