清Mac-2结合蛋白糖基化异构体水平预测E阴性慢性乙型肝炎患

StephenW

World J Gastroenterol. 2019 Mar 21;25(11):1398-1408. doi: 10.3748/wjg.v25.i11.1398.
Serum Mac-2 binding protein glycosylation isomer level predicts hepatocellular carcinoma development in E-negative chronic hepatitis B patients.
Mak LY1, To WP1, Wong DK2, Fung J1, Liu F2, Seto WK2, Lai CL2, Yuen MF2.
Author information

1
    Department of Medicine, Queen Mary Hospital, Hong Kong, China.
2
    Department of Medicine, The University of Hong Kong, Hong Kong, China.

Abstract
BACKGROUND:

Liver cirrhosis is a major risk factor for hepatocellular carcinoma (HCC) development in chronic hepatitis B (CHB). Serum Mac-2 binding protein glycosylation isomer (M2BPGi) is a novel serological marker for fibrosis. The role of M2BPGi in prediction of HCC is unknown.
AIM:

To examine the role of serum M2BPGi in predicting HCC development in hepatitis B e antigen (HBeAg)-negative patients.
METHODS:

Treatment-naive CHB patients with documented spontaneous HBeAg seroconversion were recruited. Serum M2BPGi was measured at baseline (within 3 years from HBeAg seroconversion), at 5 years and 10 years after HBeAg seroconversion and expressed as cut-off index (COI). Multivariate cox regression was performed to identify predictors for HCC development. ROC analysis was used to determine the cut-off value of M2BPGi.
RESULTS:

Among 207 patients (57% male, median age at HBeAg seroconversion 40 years old) with median follow-up of 13.1 (11.8-15.5) years, the cumulative incidence of HCC at 15 years was 7%. Median M2BPGi levels were significantly higher in patients with HCC compared to those without HCC (baseline: 1.39 COI vs 0.38 COI, P < 0.001; 5-year: 1.45 COI vs 0.47 COI, P < 0.001; 10-year: 1.20 COI vs 0.55 COI, P = 0.001). Multivariate analysis revealed age at HBeAg seroconversion [odds ratio (OR) = 1.196, 95% confidence interval (CI): 1.034-1.382, P = 0.016] and baseline M2BPGi (OR = 4.666, 95%CI: 1.296-16.802, P = 0.018) were significant factors predictive of HCC. Using a cut-off value of 0.68 COI, baseline M2BPGi yielded AUROC of 0.883 with 91.7% sensitivity and 80.8% specificity.
CONCLUSION:

High serum M2BPGi within 3 years after HBeAg seroconversion was a strong predictor for subsequent HCC development in treatment-naive HBeAg-negative CHB patients.
KEYWORDS:

Biomarker; Hepatitis B; Hepatocellular carcinoma; Liver fibrosis; Mac-2 binding protein glycosylation isomer

PMID:
    30918432
PMCID:
    PMC6429346
DOI:
    10.3748/wjg.v25.i11.1398

StephenW

World J Gastroenterol。 2019年3月21日; 25（11）：1398-1408。 doi：10.3748 / wjg.v25.i11.1398。
血清Mac-2结合蛋白糖基化异构体水平预测E阴性慢性乙型肝炎患者的肝细胞癌发展。
Mak LY1，WP1，Wong DK2，Fung J1，Liu F2，Seto WK2，Lai CL2，Yuen MF2。
作者信息

1
    中国香港玛丽医院医学系。
2
    香港大学医学系，中国香港。

抽象
背景：

肝硬化是慢性乙型肝炎（CHB）中肝细胞癌（HCC）发展的主要危险因素。血清Mac-2结合蛋白糖基化异构体（M2BPGi）是纤维化的新型血清学标志物。 M2BPGi在预测HCC中的作用尚不清楚。
目标：

检测血清M2BPGi在预测乙型肝炎e抗原（HBeAg）阴性患者HCC发展中的作用。
方法：

招募了具有记录的自发性HBeAg血清转化的未接受过治疗的CHB患者。在HBeAg血清转换后5年和10年，在基线（HBeAg血清转换后3年内）测量血清M2BPGi，并表示为截止指数（COI）。进行多变量cox回归以确定HCC发展的预测因子。 ROC分析用于确定M2BPGi的截止值。
结果：

207例患者（男性占57％，40岁时HBeAg血清学转换的中位年龄）中位随访13.1（11.8-15.5）年，HCC累积15年发生率为7％。与没有HCC的患者相比，HCC患者的中位M2BPGi水平显着升高（基线：1.39 COI vs 0.38 COI，P <0.001; 5年：1.45 COI vs 0.47 COI，P <0.001; 10年：1.20 COI vs 0.55 COI，P = 0.001）。多变量分析显示HBeAg血清学转换年龄[优势比（OR）= 1.196,95％置信区间（CI）：1.034-1.382，P = 0.016]和基线M2BPGi（OR = 4.666,95％CI：1.296-16.802，P = 0.018）是预测HCC的重要因素。使用0.68 COI的临界值，基线M2BPGi产生0.883的AUROC，灵敏度为91.7％，特异性为80.8％。
结论：

HBeAg血清学转换后3年内高血清M2BPGi是治疗初期HBeAg阴性CHB患者随后HCC发展的强预测因子。
关键词：

生物标志物;乙型肝炎;肝细胞癌;肝纤维化; Mac-2结合蛋白糖基化异构体

结论：
    30918432
PMCID：
    PMC6429346
DOI：
    10.3748 / wjg.v25.i11.1398

StephenW

https://www.wjgnet.com/1007-9327/full/v25/i11/1398.htm