By Shreeya Nanda
Japanese researchers have found that serum levels of glycosylated Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA+-M2BP) are a useful marker of not only the degree of liver fibrosis, but also progression to hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection.
The chart review, published in Hepatology Research, included 112 untreated patients, 13% of whom developed HCC during the mean 173 weeks of follow-up.
The median serum concentration of WFA+-M2BP was 0.57 cutoff index for patients with fibrosis stage F0, increasing to 0.75, 1.14, 1.03 and 1.64 cutoff index in those categorised as F1, F2, F3 and F4, respectively, with a significant association between the marker and fibrosis stage (p=0.001).
Using area under the receiver operating characteristic curve analysis, the accuracy of WFA+-M2BP levels at a cutoff of 0.94 to identify fibrosis stage F2 and above was 71.3%. This value was comparable to those obtained for other noninvasive markers, such as levels of hyaluronic acid (71.0%), type IV collagen 7S (74.7%) and serum albumin (75.9%).
The cumulative incidence of HCC was significantly higher among patients with a WFA+-M2BP concentration of at least 0.71 than those with levels below this cutoff (p=0.020).
Serum WFA+-M2BP levels at this cutoff predicted the development of HCC with a sensitivity of 93% and a specificity of 35%, report Takeji Umemura, from Shinshu University School of Medicine in Matsumoto, and colleagues.
And multivariate analysis showed that WFA+-M2BP levels of at least 0.71 were significantly and independently associated with HCC progression (p= 0.047), as were alanine aminotransferase levels of at least 80 IU/L and a platelet count lower than 14.5 x109/L.
WFA+-M2BP can be "a good indicator of fibrosis in patients with chronic HBV infection", say the investigators, a finding that is in line with previous research demonstrating the value of WFA+-M2BP as a noninvasive liver fibrosis marker in other chronic liver diseases, such as hepatitis C virus infection and primary biliary cirrhosis.
They add, however, that their results need to be validated in larger, prospective, multicentre studies.
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