Serum Wisteria floribunda Agglutinin-Positive Mac-2-Binding Protein Level Predicts Liver Fibrosis and Prognosis in Primary Biliary Cirrhosis.
OBJECTIVE
Noninvasive markers of liver fibrosis in patients with primary biliary cirrhosis (PBC) are needed for predicting disease progression. As the Wisteria floribunda agglutinin-positive Mac-2-binding protein (WFA(+)-M2BP) was recently established as a liver fibrosis glycobiomarker in chronic hepatitis C, we assessed its efficacy in evaluating liver fibrosis stage and disease progression in PBC.


METHODS
A total of 137 patients with PBC who underwent liver biopsy and serological tests for WFA(+)-M2BP were enrolled. All patients were treated with ursodeoxycholic acid. Clinical data were compared with those for other noninvasive markers (aspartate aminotransferase-to-platelet ratio, FIB-4 index, aspartate aminotransferase/alanine aminotransferase ratio, Forn's index, and Mayo score) for estimating liver fibrosis using receiver operating characteristic analysis. The association between WFA(+)-M2BP and clinical outcome (liver decompensation, liver transplantation, or death) was evaluated using the Cox proportional hazards model with stepwise method.


RESULTS
WFA(+)-M2BP was independently associated with liver fibrosis stage as determined by liver biopsy. The cutoff values of WFA(+)-M2BP for fibrosis stages ≥F1, ≥F2, ≥F3, and F4 were 0.7, 1.0, 1.4, and 2.0, respectively. The area under the receiver operating characteristic curve values for significant fibrosis, severe fibrosis, and cirrhosis were 0.979, 0.933, and 0.965, respectively. WFA(+)-M2BP was significantly superior to the other indices for the determination of significant and severe fibrosis stages. Furthermore, the WFA(+)-M2BP level at enrollment was strongly and independently associated with clinical outcome (hazard ratio 18.59, P=0.021).


CONCLUSIONS
Baseline measurements of WFA(+)-M2BP represent a simple and reliable noninvasive surrogate marker of liver fibrosis and prognosis in patients with PBC.
Division of Hepatology and Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Takeji
T
Umemura
Division of Hepatology and Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Satoru
S
Joshita
Division of Hepatology and Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Tomohiro
T
Sekiguchi
Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Yoko
Y
Usami
Division of Hepatology and Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Soichiro
S
Shibata
Division of Hepatology and Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Takefumi
T
Kimura
Division of Hepatology and Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Michiharu
M
Komatsu
Division of Hepatology and Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Akihiro
A
Matsumoto
Department of Legal Medicine, Shinshu University Hospital, Matsumoto, Japan.
Masao
M
Ota
Division of Hepatology and Gastroenterology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Eiji
E
Tanaka
D000951:Antigens, Neoplasm / Q000097:blood*; D016022:Case-Control Studies; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000209:etiology / Q000473:pathology; D008105:Liver Cirrhosis, Biliary / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D008875:Middle Aged; D037121:Plant Lectins; D011379:Prognosis; D016016:Proportional Hazards Models; D034781:Receptors, N-Acetylglucosamine; D012189:Retrospective Studies; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D000951:Antigens, Neoplasm; D002756:Cholagogues and Choleretics; D008562:Membrane Glycoproteins; D037121:Plant Lectins; D034781:Receptors, N-Acetylglucosamine; C114782:TAA90K protein, human; C040129:wisteria lectin; D014580:Ursodeoxycholic Acid