Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road 102, Hong Kong, China.
State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China.
Hepatol Int. 2019 Mar;13(2):148-156. doi: 10.1007/s12072-019-09928-5. Epub 2019 Jan 22.
Mac-2-binding protein glycosylation isomer (M2BPGi) is a novel serum diagnostic marker for liver fibrosis in various liver diseases. We aimed to evaluate its role in assessment of liver fibrosis in chronic hepatitis B infection (CHB) with reference to liver stiffness measurement (LSM).
CHB patients with LSM by transient elastography technology and retrievable serum samples were recruited. Ten-year re-assessments of LSM and M2BPGi were repeated in a patient subgroup.
240 CHB patients (M:F = 116:124; median age 47.5 years) were recruited. The median M2BPGi values for F0/F1/F2, F3 and F4 progressively increased with more advanced stages of liver fibrosis: 0.39, 0.46 and 0.82 COI, respectively (p < 0.01). M2BPGi levels correlated well with liver stiffness (r = 0.611), FIB-4 (r = 0.616), and strongly with APRI (r = 0.825) (all p < 0.001). Using cut-off values of 0.605 and 0.615 COI, the AUROCs were 0.754 and 0.799 for ≥ F3 and F4, respectively. M2BPGi identified one-quarter patients at risk of advanced fibrosis/cirrhosis otherwise classified into 'grey area' by LSM. In 86 patients with reassessment LSM, 21 (24.4%) showed significant fibrosis regression with corresponding decline in median M2BPGi level (- 0.11 COI) compared with the increase of +0.03 COI in patients without significant fibrosis regression (p = 0.011). Male gender, older age, use of potent antiviral therapy and change in serum M2BPGi were independently associated with significant fibrosis regression.
Serum M2BPGi can risk-stratify CHB patients whose liver stiffness fell into the 'grey area'. Significant fibrosis regression occurring in one-quarter patients was reflected by a reduction in M2BPGi levels at 10-year interval.
甘露糖-2-结合蛋白糖基化异构体（M2BPGi）是一种新型的血清诊断标志物，可用于各种肝脏疾病的肝纤维化诊断。本研究旨在评估其在慢性乙型肝炎（CHB）患者中评估肝纤维化的作用，并与瞬时弹性成像技术测量的肝硬度值（LSM）进行比较。
招募了接受瞬时弹性成像技术检测 LSM 的 CHB 患者，并对患者进行 10 年的 LSM 和 M2BPGi 重复评估。
共纳入 240 例 CHB 患者（男：女=116:124；中位年龄 47.5 岁）。随着肝纤维化程度的加重（F0/F1/F2、F3 和 F4），M2BPGi 值逐渐升高：分别为 0.39、0.46 和 0.82 相对单位（COI）（p<0.01）。M2BPGi 水平与 LSM（r=0.611）、FIB-4（r=0.616）显著相关，与 APRI 呈强相关（r=0.825）（均 p<0.001）。以 0.605 和 0.615 COI 为截断值，M2BPGi 对≥F3 和 F4 的 AUROC 分别为 0.754 和 0.799。M2BPGi 可识别四分之一的患者存在进展性肝纤维化/肝硬化风险，这些患者原本被 LSM 归为“灰色区域”。在 86 例接受 LSM 重新评估的患者中，21 例（24.4%）患者出现显著纤维化消退，中位数 M2BPGi 水平下降（-0.11 COI），而无显著纤维化消退的患者 M2BPGi 水平增加（+0.03 COI）（p=0.011）。男性、年龄较大、使用强效抗病毒治疗以及血清 M2BPGi 变化与显著纤维化消退独立相关。
血清 M2BPGi 可对 LSM 处于“灰色区域”的 CHB 患者进行风险分层。在四分之一的患者中，显著纤维化消退表现为 M2BPGi 水平在 10 年间隔时降低。
