Wisteria floribunda agglutinin positive human Mac‐2‐binding protein as a predictor of hepatocellular carcinoma development in chronic hepatitis C patients. Issue 10 (28th January 2015) - Tamaki, Nobuharu
Abstract : Aims: Wisteria floribunda agglutinin (WFA)‐positive human Mac‐2‐binding protein (WFA + ‐M2BP) is a new glycol marker related to liver fibrosis. The aim of the present study was to evaluate WFA + ‐M2BP as a predictor of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C. Methods: This case–control study included 14 patients with chronic hepatitis C who developed HCC and 52controls, matched for age, gender, and fibrosis stage. WFA + ‐M2BP was measured at biopsy and follow‐up. Time zero was set at the date of liver biopsy. Results: WFA + ‐M2BP increased stepwise with progression of liver fibrosis (p < 0.001). Cumulative incidence of HCC development was significantly higher in patients with WFA + ‐M2BP ≥4.2 (p < 0.001) or in those with time‐course changes in WFA + ‐M2BP (ΔWFA + ‐M2BP/year) ≥0.3 (p = 0.03). Multivariate analyses demonstrated that WFA + ‐M2BP ≥4.2 [hazard ratio (HR): 4.1, 95% confidence interval (CI): 1.1–15, p = 0.04], ΔWFA + ‐M2BP/year ≥0.3 (HR: 5.5, 95% CI: 1.5–19, p = 0.008), and AFP ≥10 ng/ml (HR: 4.7, 95% CI: 1.1–19, p = 0.03) were independent predictive factors of HCC development. Based on these data, we developed a simple scoring system to predict HCC development using these three factors. Using these scores, patients were classified into four groups; cumulative incidence of HCC development significantly increased with increasing scores (p < 0.001). Conclusions: WFA + ‐M2BP measurements and time‐course changes in WFA + ‐M2BP can be used to identify patients at high risk of HCC development. Real‐time monitoring of WFA + ‐M2BP can be a novel predictor of HCC development.