Wu Kuan-Lin, Chen Yao-Li, Ko Chih-Jan, Lin Ping-Yi, Chou Chen-Te
Department of Diagnostic Radiology, Changhua Christian Hospital, Changhua 500209, Taiwan, R.O.C.
Transplant Medicine and Surgery Research Center, Changhua Christian Hospital, Changhua 500209, Taiwan, R.O.C.
Exp Ther Med. 2020 Sep;20(3):1953-1960. doi: 10.3892/etm.2020.8922. Epub 2020 Jun 22.
The present study aimed to compare the accuracy of agglutinin-positive Mac-2-binding protein (WFA-M2BP) and magnetic resonance elastography (MRE) in determining the liver fibrosis stage in patients with chronic liver disease. A retrospective review of a prospectively maintained database was performed. The eligible patients had hepatic tumors and chronic liver disease, including hepatitis B (HBV) and HCV. All patients underwent blood sampling, MRE and hepatectomy at Changhua Christian Hospital (Changhua, Taiwan). Surgical specimens were used to determine definitive histopathological diagnoses and liver fibrosis stages. Measurement of liver stiffness was performed via MRI. The value of WFA-M2BP in each patient was also assessed. The area under the receiver operating characteristic (ROC) curve (AUC) was measured to compare the diagnostic accuracy of the two examinations. The results indicated that the serum WFA-M2BP levels were able to detect severe liver fibrosis (≥F3) in patients with chronic liver disease and performed as well as MRE in patients with HCV. Of the 238 patients enrolled in the present study, 135 had chronic HBV 75 had chronic HCV, 92 had early liver fibrosis (F1-F2) and 139 patients had advanced liver fibrosis (F3-F4). In predicting fibrosis stages ≥F3, MRE had an AUC of 0.89 with a cutoff value of 3.76 and serum WFA-M2BP had an AUC of 0.65 with a cutoff value of 1.32. MRE had higher AUCs than serum WFA-M2BP for predicting the severity based on the fibrosis stage in the total cohort and the HBV subgroup. In patients with HCV, no significant differences in diagnostic performance were identified between MRE and serum WFA-M2BP. In conclusion, determination of WFA-M2BP as a biomarker for predicting severe liver fibrosis (≥F3) is a reliable and non-invasive method and performs as well as MRE in patients with chronic liver disease, particularly those with HCV.
本研究旨在比较凝集素阳性的Mac-2结合蛋白（WFA-M2BP）和磁共振弹性成像（MRE）在确定慢性肝病患者肝纤维化分期方面的准确性。对一个前瞻性维护的数据库进行了回顾性分析。符合条件的患者患有肝肿瘤和慢性肝病，包括乙型肝炎（HBV）和丙型肝炎（HCV）。所有患者均在彰化基督教医院（台湾彰化）接受了血液采样、MRE检查和肝切除术。手术标本用于确定明确的组织病理学诊断和肝纤维化分期。通过MRI测量肝脏硬度。还评估了每位患者的WFA-M2BP值。测量受试者工作特征（ROC）曲线下面积（AUC）以比较两种检查的诊断准确性。结果表明，血清WFA-M2BP水平能够检测慢性肝病患者的严重肝纤维化（≥F3），并且在HCV患者中与MRE表现相当。在本研究纳入的238例患者中，135例患有慢性HBV，75例患有慢性HCV，92例患有早期肝纤维化（F1-F2），139例患者患有晚期肝纤维化（F3-F4）。在预测纤维化分期≥F3时，MRE的AUC为0.89，临界值为3.76，血清WFA-M2BP的AUC为0.65，临界值为1.32。在整个队列和HBV亚组中，基于纤维化分期预测严重程度时，MRE的AUC高于血清WFA-M2BP。在HCV患者中，MRE和血清WFA-M2BP在诊断性能上没有显著差异。总之，将WFA-M2BP确定为预测严重肝纤维化（≥F3）的生物标志物是一种可靠的非侵入性方法，在慢性肝病患者中，尤其是HCV患者中，其表现与MRE相当。
