Serum Wisteria floribunda agglutinin-positive human Mac-2 binding protein level predicts recurrence of hepatitis B virus-related hepatocellular carcinoma after curative resection

Abstract

Background/Aims: To investigate whether serum Wisteria floribunda agglutinin-positive human Mac-2-binding protein (WFA + -M2BP) can predict the recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative resection. Methods: Patients with chronic hepatitis B (CHB) who underwent curative resection for HCC between 2004 and 2015 were eligible for the study. Recurrence was sub-classified as early (<2 years) or late (≥2 years). Results: A total of 170 patients with CHB were selected. During the follow-up period (median, 22.6 months), 64 (37.6%) patients developed recurrence. In multivariate analyses, WFA + -M2BP level was an independent predictor of overall (hazard ratio [HR]=1.490), early (HR=1.667), and late recurrence (HR=1.416), together with male sex, des-gamma carboxyprothrombin level, maximal tumor size, portal vein invasion, and satellite nodules (all P<0.05). However, WFA + -M2BP level was not predictive of grade B-C posthepatectomy liver failure. The cutoff value that maximized the sum of sensitivity (30.2%) and specificity (90.6%) was 2.14 (area under receiver operating characteristic curve=0.632, P=0.010). Patients with a WFA + -M2BP level >2.14 experienced recurrence more frequently than those with a WFA + -M2BP level ≤2.14 (P=0.011 by log-rank test), and had poorer postoperative outcomes than those with a WFA + -M2BP level ≤2.14 in terms of overall recurrence (56.0 vs. 34.5%, P=0.047) and early recurrence (52.0 vs. 20.7%, P=0.001). Conclusions: WFA + -M2BP level is an independent predictive factor of HBV-related HCC recurrence after curative resection. Further studies should investigate incorporation of WFA + -M2BP level into tailored postoperative surveillance strategies for patients with CHB.

Clinical Utility of Mac-2 Binding Protein Glycosylation Isomer in Chronic Liver Diseases

“…Thus, M2BPGi level reflects not only liver fibrosis but also liver function. M2BPGi level is also associated with recurrence and prognosis after hepatectomy and can be used for follow-up after HCC therapy [92][93][94]. Sarcopenia has recently attracted attention as a complication of cirrhosis.…”

“…M2BPGi levels increase as the disease progresses. M2BPGi can be used to assess disease status, such as that of liver fibrosis [ 31 – 38 , 52 – 58 , 71 – 75 ], HCC risk [ 31 , 32 , 36 , 48 – 51 , 53 , 58 , 62 – 69 , 79 , 104 ], HCC recurrence risk [ 92 – 94 ], liver function [ 82 , 87 – 91 ], and prognosis of chronic liver diseases [ 82 – 86 ], with progression of the disease. In one relevant meta-analysis, the sensitivities and specificities for predicting significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis were 0.690, 0.764, and 0.818 and 0.778, 0.758, and 0.839, respectively [ 21 ].…”

Novel biomarkers for the management of chronic hepatitis B

“…In patients with undetectable HBV DNA during NA therapy, higher pre-treatment M2BPGi level was associated with increased risk of HCC development. 83,85 Cheung et al 85 85 In patients with HBV-related HCC, Kim et al 86 showed that the level of M2BPGi is an independent predictive factor of HBV-relat-ed HCC recurrence after curative resection. Also, Heo et al 87 evaluated its accuracy in assessing liver fibrosis and in predicting the risk of developing HCC in patients with CHB.…”

“…In patients with HBV-related HCC, Kim et al [ 86 ] showed that the level of M2BPGi is an independent predictive factor of HBV-related HCC recurrence after curative resection. Also, Heo et al [ 87 ] evaluated its accuracy in assessing liver fibrosis and in predicting the risk of developing HCC in patients with CHB.…”

Wisteria floribunda agglutinin-positive Mac-2-binding protein as a diagnostic biomarker in liver cirrhosis: an updated meta-analysis

“…For the prediction of HCC, a total of 8 studies with 2,240 participants were selected ( Table 2). Among them, 4 studies reported the occurrence of HCC after antiviral treatment or HBeAg seroconversion 49,50,55,56 , one study discussed the reoccurrence of HCC after curative resection 54 , and 3 studies focused on the development of HCC [51][52][53] . The WFA+-M2BP levels here were pretreatment or basal levels.…”