Significant association between serum Wisteria floribunda agglutinin-positive Mac-2-binding protein and prognosis of hepatocellular carcinoma after surgical treatment

Ming-Tsung Lin; Sherry Yueh-Hsia Chiu; Kuo-Chin Chang; Wei-Feng Li; Chee-Chien Yong; Yueh-Wei Liu; Jing-Houng Wang; Fang-Ying Kuo; Chao-Cheng Huang; Chih-Chi Wang; Chang-Chun Hsiao; Tsung-Hui Hu

Significant association between serum Wisteria floribunda agglutinin-positive Mac-2-binding protein and prognosis of hepatocellular carcinoma after surgical treatment

Am J Cancer Res. 2022 Feb 15;12(2):601-614. eCollection 2022.

Authors

Ming-Tsung Lin^{1

2}, Sherry Yueh-Hsia Chiu^{1

3}, Kuo-Chin Chang¹, Wei-Feng Li⁴, Chee-Chien Yong⁴, Yueh-Wei Liu⁴, Jing-Houng Wang¹, Fang-Ying Kuo⁵, Chao-Cheng Huang⁵, Chih-Chi Wang⁴, Chang-Chun Hsiao^{2

6}, Tsung-Hui Hu¹

Affiliations

¹ Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital Kaohsiung 83301, Taiwan.
² Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University Taoyuan 33302, Taiwan.
³ Department of Health Care Management, College of Management and Healthy Aging Research Center, Chang Gung University Taoyuan 33302, Taiwan.
⁴ Department of Surgery, Kaohsiung Chang Gung Memorial Hospital Kaohsiung 83301, Taiwan.
⁵ Department of Pathology, Kaohsiung Chang Gung Memorial Hospital Kaohsiung 83301, Taiwan.
⁶ Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital Kaohsiung 83301, Taiwan.

PMID: 35261790
PMCID: PMC8899980

Abstract

Serum Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA⁺-M2BP) is a novel marker for evaluating fibrosis and predicting the development of hepatocellular carcinoma (HCC). However, the role of WFA⁺-M2BP in the prognosis of HCC patients after curative surgery remains unknown. In this study, we aimed to evaluate the prognostic role of serum WFA⁺-M2BP in HCC patients after curative resection and liver transplantation. We enrolled 460 HCC patients (357 resection and 103 transplantation) to analyze the risk factors for HCC recurrence and patient's survival. We employed time-to-event models using univariate and multivariable Cox proportional hazards regression analyses and calculated the hazard ratios (HRs) and adjusted HRs with their corresponding 95% confidence intervals (CIs). The levels of WFA⁺-M2BP were 0.19-14.51 COI (median 1.08) in patients of hepatectomy and 0.47-19.90 COI (median 6.0) in transplant patients. The levels of WFA⁺-M2BP in liver transplant patients is much higher than that of hepatectomy patients. Overall, liver fibrotic stage was positively correlated to WFA⁺-M2BP levels (P<0.0001). This study demonstrated that elevated WFA⁺-M2BP level (COI ≥0.75) was associated with a higher HCC recurrence rate in the resection group (P<0.001). Survival analysis showed that an elevated WFA⁺-M2BP level (COI ≥1.43) is associated with a higher mortality risk after surgical resection (P=0.0088) in the univariate analysis only. In liver transplant patients, WFA⁺-M2BP level (COI ≥3.81) did not predict HCC recurrence at all, but was associated poor survival after transplantation, with a borderline significance (P=0.0943). Serum WFA⁺-M2BP is a reliable marker for liver fibrosis in the present study. It is also reliable marker to predict prognosis of HCC after surgical resection. However, the prognostic role of WFA⁺-M2BP in HCC related transplants is equivocal, which is different from that of surgical resection.

Keywords: Hepatocellular carcinoma; WFA+-M2BP; hepatitis B; hepatitis C; liver fibrosis.