Wisteria floribunda agglutinin-positive Mac-2 binding protein predicts the development of hepatocellular carcinoma in patients with non-alcoholic fatty liver disease

Miwa Kawanaka; Yasuyuki Tomiyama; Hideyuki Hyogo; Masahiko Koda; Toshihide Shima; Hiroshi Tobita; Akira Hiramatsu; Ken Nishino; Toshiaki Okamoto; Shuichi Sato; Yuichi Hara; Sohji Nishina; Hirofumi Kawamoto; Kazuaki Chayama; Takeshi Okanoue; Keisuke Hino

doi:10.1111/hepr.13054

Wisteria floribunda agglutinin-positive Mac-2 binding protein predicts the development of hepatocellular carcinoma in patients with non-alcoholic fatty liver disease

Hepatol Res. 2018 Jun;48(7):521-528. doi: 10.1111/hepr.13054. Epub 2018 Feb 9.

Authors

Affiliations

¹ Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama.
² Department of Hepatology and Pancreatology, Kawasaki Medical School, Kurashiki.
³ Department of Gastroenterology and Hepatology, JA Hiroshima General Hospital, Hatsukaichi.
⁴ Division of Medicine and Clinical Science, Faculty of Medicine, Tottori University, Yonago.
⁵ Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita.
⁶ Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo.
⁷ Department of Gastroenterology and Metabolism, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.

PMID: 29316028
DOI: 10.1111/hepr.13054

Abstract

Aim: As it is not practical to perform regular screening for hepatocellular carcinoma (HCC) in all patients with non-alcoholic fatty liver disease (NAFLD), there is a need to identify NAFLD patients who are at high risk for HCC. Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA⁺ -M2BP) has been shown to be a surrogate marker for predicting HCC as well as a liver fibrosis marker in patients with chronic hepatitis B and C. The aim of this study was to investigate whether WFA⁺ -M2BP predicts HCC development in NAFLD patients.

Methods: Serum WFA⁺ -M2BP was retrospectively measured in 331 patients with histologically proven NAFLD, 51 of whom developed HCC. The association of WFA⁺ -M2BP and HCC development in NAFLD patients was investigated.

Results: The WFA⁺ -M2BP values were significantly greater in NAFLD patients with HCC than in those without HCC among patients with liver fibrosis ≥stage 3. Multivariate analysis identified WFA⁺ -M2BP as one of the predictive factors for HCC development (odds ratio, 1.57; 95% confidence interval, 1.083-2.265; P = 0.017). The optimal cut-off index of WFA⁺ -M2BP for predicting HCC was 1.255 with specificity of 78.4% and sensitivity of 70.4%. The area under the receiver operating characteristic curve value for the prediction of HCC development was 0.806. The cumulative incidence rate of HCC was significantly greater in patients with WFA⁺ -M2BP ≥ 1.255 (n = 61) than in those with WFA⁺ -M2BP < 1.255 (n = 137) among patients who were followed up for more than 2 years after the diagnosis of NAFLD.

Conclusions: Wisteria floribunda agglutinin-positive Mac-2 binding protein predicts HCC development and is a useful surrogate marker for identifying NAFLD patients who are at a high risk for HCC.

Keywords: Wisteria floribunda agglutinin-positive Mac-2 binding protein; hepatocellular carcinoma; liver fibrosis; non-alcoholic fatty liver disease; non-alcoholic steatohepatitis.