Use of the Serum Wisteria floribunda Agglutinin-Positive Mac2 Binding Protein as a Marker of Gastroesophageal Varices and Liver-Related Events in Chronic Hepatitis C Patients
Use of the Serum Wisteria floribunda Agglutinin-Positive Mac2 Binding Protein as a Marker of Gastroesophageal Varices and Liver-Related Events in Chronic Hepatitis C Patients
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DOI：
10.3390/diagnostics10030173
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发表时间：
2020-03-01
期刊：
影响因子：
3.6
通讯作者：
Izumi, Namiki
中科院分区：
文献类型：
--
作者：
Hayashi, Tsuguru;Tamaki, Nobuharu;Izumi, Namiki
背景：一项用于缩小需要食管胃十二指肠镜检查（EGD）且极有可能患有胃食管静脉曲张（GEV）和肝脏相关事件高风险的患者范围的测试尚未得到满足。方法：对连续 166 例慢性丙型肝炎患者进行血清纤维化标志物和 EGD 测定。检查GEV分级和纤维化标志物之间的相关性以及随后发生的肝脏相关标志物和纤维化标志物。结果：紫藤凝集素阳性人 Mac-2 结合蛋白 (WFA(+)-M2BP) 水平根据 GEV 等级而增加（无 GEV 为 3.4 (0.2-18.6)，小 GEV 为 7.9 (1.8-20.0)，大 GEV 为 11.4 (4.0-20.0)；p < 0.001）。与其他血清纤维化标志物相比，WFA(+)-M2BP 的诊断准确性更高，并且在多变量分析中 WFA(+)-M2BP 是 GEV 的独立预测因子。此外，WFA(+)-M2BP 水平为 7.0 的患者一年内肝脏相关事件的累积发生率为 2.3%（p < 0.001）。 WFA(+)-M2BP > 7.0 是肝脏相关事件的显着预测因素（危险比 6.7，p = 0.004），与 Child-Pugh 分级无关。结论：WFA(+)-M2BP 可用于估计 GEV 的存在和分级，并与慢性丙型肝炎患者的肝脏相关事件相关。
Background: A test to narrow down patients who require esophagogastroduodenoscopy (EGD) with a high probability of having gastroesophageal varices (GEV) and a high-risk of liver-related events is an unmet need. Methods: The measurement of serum fibrosis markers and EGD was performed in 166 consecutive chronic hepatitis C patients. The correlation between the grades of GEV and fibrosis markers and the subsequent occurrence of liver-related and fibrosis markers were examined. Results: Wisteria floribunda agglutinin-positive human Mac-2 binding protein (WFA(+)-M2BP) levels increased according to the grade of GEV (3.4 (0.2-18.6) for no GEV, 7.9 (1.8-20.0) for small GEV, and 11.4 (4.0-20.0) for large GEV; p < 0.001). The diagnostic accuracy of the WFA(+)-M2BP was superior compared to other serum fibrosis markers, and WFA(+)-M2BP was an independent predictor of GEV in the multivariate analysis. Furthermore, the cumulative incidence of liver-related events at one year was 2.3% in patients with WFA(+)-M2BP levels 7.0 (p < 0.001). WFA(+)-M2BP > 7.0 was a significant predictive factor for liver-related events (Hazard ratio 6.7, p = 0.004) independent of Child-Pughclass. Conclusions: WFA(+)-M2BP could be used to estimate the presence and grade of GEV and is linked to liver-related events in chronic hepatitis C patients.