Abstract
AIMThe risk factors for hepatocellular carcinoma (HCC) development in chronic hepatitis B (CHB) patients with undetectable serum HBV DNA under nucleos(t)ide analogue (NA) therapy are not well defined. We aimed to examine the relationship between Wisteria floribunda agglutinin-positive human Mac-2 binding protein (WFA+-M2BP) and HCC development in these patients.ResultsThere was a significant difference in the median levels of pre-treatment WFA+-M2BP between the HCC and control groups (0.67 vs 0.41 COI, respectively, p < 0.001). Among patients with cirrhosis, the median level of WFA+-M2BP was higher in HCC group than in control group (0.74 vs 0.47 COI, respectively, p = 0.014). Among patients without cirrhosis, the median level of WFA+-M2BP of HCC group was also higher (0.48 vs 0.28 COI, respectively, p = 0.002). With a cutoff value of 0.69, the AUROC of pre-treatment WFA+-M2BP to predict HCC development for the whole cohort was 0.70. With cutoff values of 0.69 and 0.34, the AUROCs to predict HCC were 0.67 and 0.77 for patients with and without cirrhosis, respectively.Materials and MethodsFifty-seven NA-treated patients with undetectable HBV DNA who developed HCC were compared with 57 controls (matched with demographics and treatment duration). WFA+-M2BP levels were measured, and expressed as cutoff index (COI). Subgroup analyses were also performed in patients with and without cirrhosis.ConclusionsA higher pre-treatment WFA+-M2BP level was associated with an increased risk of HCC development in patients with undetectable HBV DNA under NA therapy. Further longitudinal studies are required to examine the role of WFA+-M2BP as an accessory risk marker for HCC development.
Highlights
Hepatitis B virus (HBV) infection is one of the commonest chronic infections, affecting 248 million people worldwide [1], with more than 1 million people dying from HBV-related diseases annually [2]
There was a significant difference in the median levels of pre-treatment WFA+-M2BP between the hepatocellular carcinoma (HCC) and control groups (0.67 vs 0.41 cutoff index (COI), respectively, p < 0.001)
The median level of WFA+-M2BP was higher in HCC group than in control group (0.74 vs 0.47 COI, respectively, p = 0.014)
Summary
Hepatitis B virus (HBV) infection is one of the commonest chronic infections, affecting 248 million people worldwide [1], with more than 1 million people dying from HBV-related diseases annually [2]. The risk of HCC is significantly increased in case of cirrhosis, due to the activation of oncogenes, overexpression of growth factors and inactivation of tumor suppressor genes [5]. It is of paramount importance in assessing the severity of liver fibrosis and cirrhosis, in an accurate and timely manner. Available non-invasive methods include direct and indirect serum markers, transient elastography, and magnetic resonance (MR) elastography. Each of these investigatory modalities is associated with certain disadvantages [7]. The test has the advantages of being simple, rapid and noninvasive
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