Wisteria floribunda agglutinin positive human Mac-2-binding protein as a predictor of hepatocellular carcinoma development in chronic hepatitis C patients

AimsWisteria 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. MethodsThis 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. ResultsWFA(+)-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 (WFA(+)-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], WFA(+)-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). ConclusionsWFA(+)-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.