Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2019; 25(11): 1398-1408
Published online Mar 21, 2019. 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
Lung-Yi Mak, Wai-Pan To, Danny Ka-Ho Wong, James Fung, Fen Liu, Wai-Kay Seto, Ching-Lung Lai, Man-Fung Yuen
Lung-Yi Mak, Wai-Pan To, James Fung, Department of Medicine, Queen Mary Hospital, Hong Kong, China
Danny Ka-Ho Wong, Fen Liu, Wai-Kay Seto, Ching-Lung Lai, Man-Fung Yuen, Department of Medicine, The University of Hong Kong, Hong Kong, China
Danny Ka-Ho Wong, James Fung, Wai-Kay Seto, Ching-Lung Lai, Man-Fung Yuen, State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China
Author contributions: Mak LY and To WP were involved in drafting the manuscript. Wong DKH was involved in performing laboratory tests and collecting the data. Fung J was involved in data acquisition, statistical analysis, and language editing of the manuscript. Seto WK was involved in interpretation of the data and critical revision of the manuscript. Lai CL was involved in critical revision of the manuscript. Yuen MF was involved in study concept and design, analysis and interpretation of data, critical revision of manuscript, and overall study supervision. All authors have approved the final draft submitted.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board/ Ethics Committee of the University of Hong Kong and the Hong Kong West Cluster of Hospital Authority.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data and stored serum samples that were obtained after each patient agreed to such storage for clinical research by informed consent in previous studies.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This 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 Non Commercial (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:
Corresponding author: Man-Fung Yuen, DSc, FRCP (C), MBBS, MD, MRCP, PhD, Professor, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam Road 102, Hong Kong, China.
Telephone: +86-852-22553994 Fax: +86-852-28162863
Received: December 15, 2018
Peer-review started: December 17, 2018
First decision: January 6, 2019
Revised: January 22, 2019
Accepted: January 26, 2019
Article in press: January 26, 2019
Published online: March 21, 2019
Research background

Hepatocellular carcinoma (HCC) is the most dreadful complication of chronic hepatitis B infection (CHB). Recent research showed that serum Mac-2 binding protein glycosylation isomer (M2BPGi) is a novel biomarker for liver fibrosis and cirrhosis, and preliminary studies reported its potential role in predicting risk of HCC in both untreated and treated patients.

Research motivation

The current literature has limited data on the role of serum M2BPGi in predicting risk of HCC in patients with hepatitis B e antigen (HBeAg) seroconversion (HBeAg-negative disease), and studies with long-term follow-up are lacking.

Research objectives

We would like to know if serum M2BPGi can predict subsequent HCC development in untreated CHB patients who underwent HBeAg seroconversion.

Research methods

This is a retrospective study by a tertiary center in Hong Kong. Treatment-naive patients with documented spontaneous HBeAg seroconversion were recruited. Serum M2BPGi was measured at baseline, at 5-years and 10-years from HBeAg-seroconversion. We investigated the relationship between serum M2BPGi levels and subsequent HCC development.

Research results

The cumulative HCC incidence at 15 years was 7% among 207 recruited patients (median follow-up of 13.1 years). Serum M2BPGi was significantly higher in patients with HCC compared to those without HCC at all 3 time points (all P < 0.01). Baseline serum M2BPGi was significantly associated with HCC development (odds ratio of 4.666, P = 0.018). The area under the receivor operating characteristics curve for baseline M2BPGI was 0.883, with sensitivity and specificity of 91.7% and 80.8%, respectively, when the derived cut-off value of 0.68 cut-off index was used to predict HCC development.

Research conclusions

High serum M2BPGi level at HBeAg seroconversion was a strong predictor for subsequent HCC development in CHB patients.

Research perspectives

The derived cut-off value of serum M2BPGi would be a valuable tool for risk stratification regarding HCC risk prediction. Further validation studies are warranted.