Use of Wisteria Floribunda Agglutinin-Positive Human Mac-2 Binding Protein in Assessing Risk of Hepatocellular Carcinoma Due to Hepatitis B Virus

Wisteria floribunda agglutinin-positive human Mac-2 binding protein (WFA +-M2BP) is a serologic marker corresponding with degree of hepatic fibrosis. We evaluated its accuracy in assessing hepatic fibrosis and in predicting the risk of developing hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). In a 5-year period (2009-2013), a total of 95 CHB patients with available serum WFA +-M2BP assay and transient elastography assessment [to assess liver stiffness (LS)] who had undergone liver biopsy were recruited for retrospective analysis. Areas under the receiver operating characteristic curve for predicting fibrosis stages via serum WFA +-M2BP level were as follows: ≥F2, 0.688; ≥F3, 0.694; and F4, 0.704 (all P<0.05). During the follow-up period (median, 45 months), HCC developed in 7 patients (7.4%). In patients with HCC, age, use of antiviral therapy, test parameters (HBV DNA, WFA +-M2BP, and LS determinations), and histologic stage of fibrosis were all significantly greater than in those free of HCC, whereas platelet count was significantly lower (all P<0.05). On multivariate analysis, WFA +-M2BP was found independently predictive of emergent HCC [hazard ratio (HR)=2.375; P=0.036], although LS and histologic stage of fibrosis were not (P>0.05). Risk of developing HCC was significantly greater in patients with high WFA +-M2BP levels (≥1.8) (adjusted HR=11.5; P=0.025). Cumulative incidence rates of HCC were also significantly higher in patients with high (vs. low) levels of WFA +-M2BP (log-rank test, P=0.016). WFA +-M2BP determination significantly reflected degree/extent of hepatic fibrosis and independently predicted the risk of developing HCC in patients with CHB.