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Wisteria floribunda agglutinin‐positive Mac‐2 binding protein predicts the development of hepatocellular carcinoma in patients with non‐alcoholic fatty liver disease
Author(s) -
Kawanaka Miwa,
Tomiyama Yasuyuki,
Hyogo Hideyuki,
Koda Masahiko,
Shima Toshihide,
Tobita Hiroshi,
Hiramatsu Akira,
Nishino Ken,
Okamoto Toshiaki,
Sato Shuichi,
Hara Yuichi,
Nishina Sohji,
Kawamoto Hirofumi,
Chayama Kazuaki,
Okanoue Takeshi,
Hino Keisuke
Publication year - 2018
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13054
Subject(s) - hepatocellular carcinoma , medicine , fatty liver , gastroenterology , confidence interval , odds ratio , stage (stratigraphy) , fibrosis , pathology , disease , biology , paleontology
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.