Clinical implications of serum Mac-2-binding protein (M2BPGi) during regular follow-up of patients with biliary atresia

Abstract

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.

Biomarkers for Diagnosis and Post-Kasai Portoenterostomy Prognosis of Biliary Atresia: Systematic Review and Meta-Analysis

“…If some noninvasive methods could be uncovered to predict the occurrence of cirrhosis, it enables to prevent the development of liver failure and the need of liver transplantation in BA patients effectively. Three of our included 9 studies found that APRi was a useful noninvasive tool in predicting post-KPE cirrhosis (Grade B, level 2a) [62][63][64]. The sensitivity, speci city and AUC of APRi with different cut-off value in these studies ranged from 71-91%, 81-84% and 0.81 to 0.88, respectively ( Table 3).…”

“…Original [64] Abbreviations: BA, biliary atresia; MMP-7, matrix metallopeptidase-7; IL-33, interleukin 33; GGT, γ-glutamyl transferase; APRi, aspartate aminotransferase to platelet ratio index; post-KPE, after Kasai portoenterostomy; ELISA, enzyme-linked immunosorbent assay; CLEIA, chemiluminescent enzyme immunoassay. Biomarkers for differentiating BA to non-BA…”

“…Three case-control studies concluded that APRi was a sensitive biomarker to predict post-KPE liver brosis (Grade B, level 2a) [63,64,74]. We calculated the diagnostic performance of APRi in predicting the post-KPE signi cant liver brosis from 2 of these 3 studies [63,64]. With different cut-off value of APRi, the sensitivity, speci city and AUC of 2 included studies ranged from 61-62%, 76-88% and 0.75 to 0.88, respectively ( Table 3).…”

“…Thirty-one studies [21-24, 31-56, 68] reported a single-center evidence of biomarkers related to BA diagnosis or post-KPE prognosis, and 8 studies [25-30, 65, 66] provided multicenter evidence but was unable to be included for meta-analysis. The data from the remaining 12 studies were constructed with 2×2 contingency tables and the performance of biomarkers for the early diagnosis [20, 57-61, 67, 69, 70] or post-KPE prognosis of BA [62][63][64] were evaluated. All biomarkers with evidence-level less than 3a in identi cations of BA diagnosis or post-KPE prognosis were summarized (eTable 2 in Supplementary materials, page 2-3).…”

“…2. In the patient selection domain, there was a high risk of bias in 7 studies because they did not avoid case-control design [20,57,60,64,67,69,70]. Four studies showed a high risk of bias in the index test domain because their index test results were not interpreted without knowledge of the results of the reference standard [20,60,64,70].…”