血清M2BPGi水平在慢性乙型肝炎病毒感染者肝纤维化和肝硬化

StephenW

Clin Transl Gastroenterol. 2018 Jun 19;9(6):163. doi: 10.1038/s41424-018-0020-9.
Role of serum M2BPGi levels on diagnosing significant liver fibrosis and cirrhosis in treated patients with chronic hepatitis B virus infection.
Mak LY1, Wong DK1,2, Cheung KS1, Seto WK1,2, Lai CL1,2, Yuen MF3,4.
Author information

1
    Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
2
    State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China.
3
    Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China. [email protected].
4
    State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China. [email protected].

Abstract
BACKGROUND:

Mac-2-binding protein glycosylation isomer (M2BPGi), a novel serum marker for liver fibrosis, was seldom studied in chronic hepatitis B (CHB). We aimed to evaluate its role on diagnosing significant fibrosis and cirrhosis in treated CHB patients.
METHODS:

CHB patients treated with nucleos(t)ide analogues (NAs) with baseline liver biopsies and retrievable serum samples were recruited. Paired liver biopsies were performed in patient subgroups at 1 and 3 years.
RESULTS:

In total, 327 NA-treated CHB patients (M:F = 229:98; median age 38.1 years) were recruited. The median M2BPGi values were 0.26, 0.34, 0.57 and 1.21 cutoff index (COI), in liver histology with Ishak F0-1, F2, F3 and F4, respectively (p < 0.01). M2BPGi levels correlated with the Ishak scores (ρ = 0.312, p < 0.001). Using the cutoff values of 0.25, 0.45 and 0.96 COI for ≥F2, ≥F3 and F4, the AUROCs were 0.653, 0.795 and 0.914, respectively. Multivariate analysis with several other serum indices showed that M2BPGi was the most significant independent factor for ≥F3 (OR: 8.197, 95% CI: 2.699-24.897, p < 0.001). In patient subgroups with serial liver biopsies, both the proportion of F3/F4 and M2BPGi decreased at 1 year (8.3% vs. 2.8% and 0.32 vs. 0.21 COI, respectively; both p < 0.001). Histological fibrosis progression after ≥3 years of NA therapy accompanied with an increase in M2BPGi level, compared to patients without progression (+0.14 vs -0.03 COI, p = 0.045).
CONCLUSION:

Serum M2BPGi is a reliable non-invasive marker for diagnosing ≥F2, ≥F3 and F4. It is the only significant marker for ≥F3 among several other indices. NA produced concordant dynamic changes in M2BPGi levels and histological fibrosis.

PMID:
    29915243
DOI:
    10.1038/s41424-018-0020-9

StephenW

Clin Transl Gastroenterol。 2018年6月19日; 9（6）：163。 doi：10.1038 / s41424-018-0020-9。
血清M2BPGi水平在慢性乙型肝炎病毒感染者肝纤维化和肝硬化诊断中的作用。
Mak LY1，Wong DK1,2，Cheung KS1，Seto WK1,2，Lai CL1,2，Yuen MF3,4。
作者信息

1
    香港大学玛丽医院医学系，香港，中国。
2
    香港大学肝脏研究国家重点实验室，中国香港。
3
    香港大学玛丽医院医学系，香港，中国。 [email protected]。
4
    香港大学肝脏研究国家重点实验室，中国香港。 [email protected]。

抽象
背景：

在慢性乙型肝炎（CHB）中很少研究Mac-2结合蛋白糖基化异构体（M2BPGi），一种新的肝纤维化血清标志物。我们旨在评估其在诊断CHB患者显着纤维化和肝硬化中的作用。
方法：

用核苷（酸）类似物（NAs）治疗的具有基线肝活检和可检索血清样品的CHB患者被招募。在1和3年时在患者亚组中进行配对肝活检。
结果：

共招募327名NA治疗的慢性乙型肝炎患者（男：女= 229：98;中位年龄38.1岁）。在肝组织学方面，Ishak F0-1，F2，F3和F4分别使中位M2BPGi值分别为0.26,0.34,0.57和1.21临界指数（COI）（p <0.01）。 M2BPGi水平与Ishak评分相关（ρ= 0.312，p <0.001）。对于≥F2，≥F3和F4，使用0.25,0.45和0.96 COI的截断值，AUROC分别为0.653,0.795和0.914。与其他几项血清指标的多变量分析显示M2BPGi是≥F3的最显着独立因素（OR：8.197,95％CI：2.699-24.897，p <0.001）。在连续肝活检患者亚组中，F3 / F4和M2BPGi的比例在1年时下降（分别为8.3％比2.8％和0.32比0.21 COI;均p <0.001）。与无进展的患者相比，≥3年的NA治疗后组织学纤维化进展伴随着M2BPGi水平的升高（+0.14 vs -0.03 COI，p = 0.045）。
结论：

血清M2BPGi是诊断≥F2，≥F3和F4的可靠的非侵入性标记物。它是几个其他指数中≥F3的唯一重要标志。 NA在M2BPGi水平和组织学纤维化中产生一致的动态变化。

结论：
    29915243
DOI：
    10.1038 / s41424-018-0020-9