Published online Mar 21, 2019. doi: 10.3748/wjg.v25.i11.1398
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
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.
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.
We would like to know if serum M2BPGi can predict subsequent HCC development in untreated CHB patients who underwent HBeAg seroconversion.
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.
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.
High serum M2BPGi level at HBeAg seroconversion was a strong predictor for subsequent HCC development in CHB patients.
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.