Abstract
Introduction: The aim of the current analysis was to evaluate the prognostic value of Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA+-M2BP) in predicting overall survival for patients with early-stage hepatocellular carcinoma (ESHCC) after liver resection. Method: Data were extracted from our prospective maintained database to identify ESHCC patients treated at Changhua Christian hospital between 2009 and 2016. Exclusion criteria were stage III/IV HCC, lost to follow up, and non-cancer related death. Post-operative survival rates were compared according to WFA+-M2BP and tumor stage. Result: Six hundred and ten patients were identified and 128 were removed after application of the exclusion criteria, this left a final cohort of 482 patients. The number of cases of HBV HCC, HCV HCC, cryptogenic HCC, alcoholic HCC, and HBV/HCV coinfection HCC were 240 (49.8%), 172 (35.7%), 37 (7.7%), 21 (4.4%) and 12 (2.5%) respectively. The median follow up time was 4.27 years, and cancer related death occurred in 141 (29.3%) patients. Age (p = 0.06), cancer stage (p = 0.02) and WFA+-M2BP level (p < 0.001) were identified as independent risk factors for poor overall survival in patient with ESHCC. The optimal cutoff point to predict overall survival was 1.12 COI. The overall survival rates for ESHCC at 3 and 5 years for patients with WFA+-M2BP <1.12 were 0.92 and 0.90 respectively, and for WFA+-M2BP >1.12 were 0.75 and 0.64 (p < 0.001). During the analysis of the best model for survival prediction, serum WFA+-M2BP level exhibited the highest log-likelihood and the lowest AIC value (log likelihood -792; AIC 1586). Conclusion: It was demonstrated that serum WFA+-M2BP level provided important prognostic information after curative hepatic resection in our study. Future studies with larger numbers of patients are necessary for the validation of serum WFA+-M2BP level as the method of choice for other population.
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