Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2022; 14(7): 1480-1494
Published online Jul 27, 2022. doi: 10.4254/wjh.v14.i7.1480
Pre-sarcopenia and Mac-2 binding protein glycosylation isomer as predictors of recurrence and prognosis of early-stage hepatocellular carcinoma
Masato Nakai, Kenichi Morikawa, Shunichi Hosoda, Sonoe Yoshida, Akinori Kubo, Yoshimasa Tokuchi, Takashi Kitagataya, Ren Yamada, Masatsugu Ohara, Takuya Sho, Goki Suda, Koji Ogawa, Naoya Sakamoto
Masato Nakai, Kenichi Morikawa, Shunichi Hosoda, Sonoe Yoshida, Akinori Kubo, Yoshimasa Tokuchi, Takashi Kitagataya, Ren Yamada, Masatsugu Ohara, Takuya Sho, Goki Suda, Koji Ogawa, Naoya Sakamoto, Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo 060-8638, Japan
Author contributions: Nakai M and Morikawa K planned the contents of manuscript; Nakai M, Morikawa K, Hosoda S, Yoshida S, Kubo A, Tokuchi Y, Kitagataya T, Yamada R, Ohara M, Sho T, Suda G, Ogawa K, and Sakamoto N collected the data; Nakai M and Morikawa K analyzed the data and drafted the manuscript; all authors revised the manuscript.
Institutional review board statement: The study protocol was approved by the Institutional Ethics Committee of Hokkaido University (IRB no. 015-1412) and conformed to the ethical guidelines of the Declaration of Helsinki.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kenichi Morikawa, MD, PhD, Associate Professor, Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo 0608638, Hokkaido, Japan. kenichi.morikawa@med.hokudai.ac.jp
Received: February 25, 2022
Peer-review started: February 25, 2022
First decision: April 8, 2022
Revised: April 20, 2022
Accepted: June 22, 2022
Article in press: June 22, 2022
Published online: July 27, 2022
Abstract
BACKGROUND

The Mac-2 binding protein glycosylation isomer (M2BPGi), a fibrosis marker in various liver diseases, is reportedly a prognostic marker in patients with hepatocellular carcinoma (HCC) who underwent hepatectomy.

AIM

To evaluate whether the M2BPGi value, M2BP, and pre-sarcopenia before radiofrequency ablation (RFA) could be useful recurrence and prognostic markers in patients with early-stage HCC.

METHODS

In total, 160 patients with early-stage primary HCC treated with RFA were separately analyzed as hepatitis C virus (HCV)-positive and HCV-negative. Factors contributing to recurrence and liver-related death, including M2BP, M2BPGi, and skeletal muscle mass index, were statistically analyzed. Eighty-three patients were HCV-positive and 77 were HCV-negative.

RESULTS

In HCV-positive patients, only des-γ-carboxy-prothrombin ≥ 23 mAU/mL was a significant poor prognostic factor affecting survival after RFA. In HCV-negative patients, M2BPGi ≥ 1.86 cutoff index was significantly associated with tumor recurrence, while M2BP was not. M2BPGi ≥ 1.86 cutoff index (hazard ratio, 4.89; 95% confidence interval: 1.97-12.18; P < 0.001) and pre-sarcopenia (hazard ratio, 3.34, 95% confidence interval: 1.19-9.37; P = 0.022) were independent significant poor prognostic factors in HCV-negative patients.

CONCLUSION

In HCV-negative patients with primary HCC treated with RFA, lower M2BPGi contributed to a lower tumor recurrence rate and longer survival period. Pre-sarcopenia contributed to the poor prognosis independently in HCV-negative patients. These factors might be useful recurrence and prognostic markers for early-stage primary HCC.

Keywords: Mac-2 binding protein, Mac-2 binding protein glycosylation isomer, Pre-sarcopenia, Primary hepatocellular carcinoma, Radiofrequency ablation

Core Tip: Hepatocellular carcinoma (HCC) is prone to recurrence, even if cured at an early stage. Pre-sarcopenia is a poor prognostic factor in the elderly population. The usefulness of the Mac-2 binding protein glycosylation isomer (M2BPGi) to treat HCC has recently attracted attention. In this study, we investigated the recurrence and prognostic factors in patients who underwent radiofrequency ablation for early-stage HCC. Based on our data, pre-sarcopenia and higher M2BPGi, but not M2BP, were useful predictors of the recurrence and poor prognosis of early-stage primary HCC in hepatitis C virus-negative patients.