본문 바로가기
KERD
논문KCI 등재

만성 B형간염에 의한 간세포암 환자에서 간경변 진단을 위한 M2BPGi, Fibroscan 및 기타 간섬유화 표지자 비교

Comparison of Mac-2 Binding Protein Glycosylation Isomer, Fibroscan, and Other Fibrosis Markers for Assessing Liver Cirrhosis in Patients with Chronic Hepatitis B Virus-mediated Hepatocellular Carcinoma

강은숙|신동현|김종만|조재원|유인영|박형두|하상윤|이경훈|곽금연
대한진단검사의학회 (Korean Society For Laboratory Medicine)|2020.04|Laboratory Medicine Online|제10권 제2호|pp. 109-115|DOI 10.3343/lmo.2020.10.2.109

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

Hepatocellular carcinomaLiver cirrhosisM2BPGi

초록

배경: 바이러스성 간염에 의한 간섬유화의 최종 단계는 간경변 (cirrhosis)이다. 혈청 Mac-2 binding protein glycosylation isomer (M2BPGi)는 간섬유화를 진단하고 추척관찰 하는데 사용될 수 있는 표지자이다. 본 연구에서는 간 조직검사 결과를 기준으로 만성B형간염에 의한 간경변 상태를 분별하는데 혈청 M2BPGi가 유용한지 평가하였다. 방법: 만성 B형간염으로 인한 간세포암 환자군 312명과 건강한 대조군 105명으로부터 얻은 혈청으로 M2BPGi cut-off index (COI)를 측정하였다. 간섬유화 표지자인 FIB-4, APRI, Fibroscan 등의 결과를 M2BPGi와 비교분석하였다. 결과: 대한병리학회 소화기병리연구회에서 정한 조직학적 간섬유화등급에서 간경변 상태에 해당하는 F4 환자군은 165명(52%)으로,섬유성 격막을 보이는 F3 환자군과 비교 시 M2BPGi, platelet count,APRI, FIB-4와 Fibroscan은 유의한 차이를 보였다. M2BPGi 2+ (COI≥3) 결과는 F4 환자군에서 8%, F3 환자군에서 1%로 관찰되어 낮은 빈도를 보였다. 다중회귀분석에서 M2BPGi는 다른 혈청 표지자들보다 간경변에 대한 교차비가 높았고, M2BPGi 2+의 경우, Fibroscan 결과에서 F3 및 F4 단계와 비슷한 교차비를 보였다. 결론: M2BPGi는 만성 B형간염 환자의 간경변 여부를 판단함에있어 Fibroscan 검사보다 유용하지 않았으며, 제한적으로 간섬유화 상태를 반영하였다.

Abstract

Background: Liver cirrhosis is advanced stage of hepatic fibrosis caused by viral hepatitis. Mac-2 binding protein glycosylation isomer (M2BPGi) is a serum marker to diagnose and evaluate hepatic fibrosis progression. In this study, we evaluated the efficacy of serum M2BPGi to predict chronic hepatitis B (HBV)-mediated cirrhosis by liver biopsy. Methods: M2BPGi cut-off index (COI) was evaluated from 312 patients with chronic HBV-mediated hepatocellular carcinoma and 105 healthy controls. Comparative analysis was performed with conventional hepatic fibrosis markers such as fibrosis index based on four factors (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), and Fibroscan. Results: Korean Study Group for Pathology of Digestive Diseases classified 165 (52%) patients with histological stage F4 liver cirrhosis. Comparison of cases with stage F4 cirrhosis and stage F3 septal fibrosis revealed significant difference between M2BPGi, platelet count, APRI, FIB-4, and Fibroscan prediction. M2BPGi 2+ (COI ≥3) was found to be 8% in patients with F4 cirrhosis and 1% in patients with F3 fibrosis. In multi-regression analysis, M2BPGi showed higher odds ratio than that of other serum markers while M2BPGi 2+ showed comparable odds ratio to Fibroscan F3 and F4 assessment. Conclusions: In patients with chronic HBV-mediated hepatocellular carcinoma, M2BPGi was neither comprehensive nor as effective as Fibroscan in assessing liver cirrhosis and fibrosis progression.

참고문헌 (24)

  1. Adams LA, "Biomarkers of liver fibrosis", J Gastroenterol Hepatol, 26, pp.802~809 (2011)
  2. European Association for Study of Liver and Asociacion Latinoamericana para el Estudio del Higado, "EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis", J Hepatol, 63, pp.237~264 (2015)
  3. Kuno A, "A serum"sweet-doughnut"protein facilitates fibrosis evaluation and therapy assessment in patients with viral hepatitis", Sci Rep, 3, pp.1065~ (2013)
  4. Toshima T, "A novel serum marker, glycosylated Wisteria floribunda agglutinin-positive Mac-2 binding protein(WFA(+)-M2BP), for assessing liver fibrosis", J Gastroenterol, 50, pp.76~84 (2015)
  5. Fujiyoshi M, "Clinicopathological characteristics and diagnostic performance of Wisteria floribunda agglutinin positive Mac-2-binding protein as a preoperative serum marker of liver fibrosis in hepatocellular carcinoma", J Gastroenterol, 50, pp.1134~1144 (2015)
  6. Umemura T, "Serum Wisteria floribunda agglutinin-positive Mac-2-binding protein level predicts liver fibrosis and prognosis in primary biliary cirrhosis", Am J Gastroenterol, 110, pp.857~864 (2015)
  7. Nishikawa H, "Serum Wisteria floribunda agglutinin-positive Mac-2-binding protein for patients with chronic hepatitis B and C : a comparative study", J Viral Hepat, 23, pp.977~984 (2016)
  8. Dong Wook Jekarl, "Diagnosis of Liver Fibrosis With Wisteria floribunda Agglutinin-Positive Mac-2 Binding Protein (WFAM2BP) Among Chronic Hepatitis B Patients", Annals of Laboratory Medicine, 38(4), pp.348~354 (2018), 대한진단검사의학회
  9. 문희원, "Usefulness of Enhanced Liver Fibrosis, Glycosylation Isomer of Mac-2 Binding Protein, Galectin-3, and Soluble Suppression of Tumorigenicity 2 for Assessing Liver Fibrosis in Chronic Liver Diseases", Annals of Laboratory Medicine, 38(4), pp.331~337 (2018), 대한진단검사의학회
  10. Yamasaki K, "Elevated serum levels of Wisteria floribunda agglutinin-positive human Mac-2 binding protein predict the development of hepatocellular carcinoma in hepatitis C patients", Hepatology, 60, pp.1563~1570 (2014)
  11. Heo JY, "Use of Wisteria floribunda agglutinin-positive human Mac-2 binding protein in assessing risk of hepatocellular carcinoma due to hepatitis B virus", Medicine(Baltimore), 95, pp.e3328~ (2016)
  12. Kim SU, "Wisteria floribunda agglutinin-positive human Mac-2 binding protein predicts the risk of HBV-related liver cancer development", Liver Int, 37, pp.879~887 (2017)
  13. Shirabe K, "Mac-2 binding protein glycan isomer(M2BPGi)is a new serum biomarker for assessing liver fibrosis : more than a biomarker of liver fibrosis", J Gastroenterol, 53, pp.819~826 (2018)
  14. Li Q, "The gamma-glutamyl-transpeptidase to platelet ratio does not show advantages than APRI and Fib-4 in diagnosing significant fibrosis and cirrhosis in patients with chronic hepatitis B : a retrospective cohort study in China", Medicine(Baltimore), 95, pp.e3372~ (2016)
  15. Kim SU, "Transient elastography in chronic hepatitis B : an Asian perspective", World J Gastroenterol, 16, pp.5173~5180 (2010)
  16. Kuno A, "Reconstruction of a robust glycodiagnostic agent supported by multiple lectin-assisted glycan profiling", Proteomics Clin Appl, 7, pp.642~647 (2013)
  17. Munteanu M, "Noninvasive biomarkers for the screening of fibrosis, steatosis and steatohepatitis in patients with metabolic risk factors : FibroTest-FibroMax experience", J Gastrointestin Liver Dis, 17, pp.187~191 (2008)
  18. 신정우, "비침습적 간섬유화 검사의 종류와 의의", 대한소화기학회지, 68(1), pp.4~9 (2016), 대한소화기학회
  19. Busch K, "Natural history of chronic hepatitis B virus infection", Med Microbiol Immunol, 204, pp.5~10 (2015)
  20. Wei B, "M2BPGi as a potential diagnostic tool of cirrhosis in Chinese patients with hepatitis B virus infection", J Clin Lab Anal, 32, pp.e22261~ (2018)
  21. Ishii A, "Clinical implications of serum Wisteria floribunda agglutinin-positive Mac-2-binding protein in treatment-naïve chronic hepatitis B", Hepatol Res, 47, pp.204~215 (2017)
  22. Mak LY, "Role of serum M2BPGi levels on diagnosing significant liver fibrosis and cirrhosis in treated patients with chronic hepatitis B virus infection", Clin Transl Gastroenterol, 9, pp.163~ (2018)
  23. Xu H, "Accuracy of M2BPGi, compared with Fibro Scan®, in analysis of liver fibrosis in patients with hepatitis C", BMC Gastroenterol, 17, pp.62~ (2017)
  24. Nakamura M, "Serum microRNA-122 and Wisteria floribunda agglutinin-positive Mac-2 binding protein are useful tools for liquid biopsy of the patients with hepatitis B virus and advanced liver fibrosis", PLoS One, 12, pp.e0177302~ (2017)

관련 논문AI추천

Clinical Utility of Mac-2 Binding Protein Glycosylation Isomer in Chronic Liver DiseasesIzumi Namiki, Kurosaki Masayuki, Loomba Rohit, Tamaki Nobuharu대한진단검사의학회 · Annals of Laboratory Medicine2021 · 제41권 제1호Diagnosis of Liver Fibrosis With Wisteria floribunda Agglutinin-Positive Mac-2 Binding Protein (WFAM2BP) Among Chronic Hepatitis B Patients권정현, 김명신, 김용구, 성필수, 유혜인, 윤승규, 이성원, 이승옥, 최현주, Dong Wook Jekarl대한진단검사의학회 · Annals of Laboratory Medicine2018 · 제38권 제4호만성 바이러스간질환에서 간섬유화의 다양한 비침습 혈청표지자검사의 비교김선민, 김태엽, 노영욱, 손주현, 오영하, 은창수, 전용철, 한동수대한간학회 · Clinical and Molecular Hepatology2009 · 제15권 제4호Comparison of Non-Invasive Clinical Algorithms for Liver Fibrosis in Patients With Chronic Hepatitis B to Reduce the Need for Liver Biopsy: Application of Enhanced Liver Fibrosis and Mac-2 Binding Protein Glycosylation IsomerChoe Won Hyeok, Hur Mina, Lee Chae Hoon, Moon Hee-Won, Park Mikyoung대한진단검사의학회 · Annals of Laboratory Medicine2022 · 제42권 제2호Diagnostic Efficacy of Serum Mac-2 Binding Protein Glycosylation Isomer and Other Markers for Liver Fibrosis in Non-Alcoholic Fatty Liver DiseasesHan Man-Hoon, Hur Keun, Jang Se Young, Kim Gyeonghwa, Kweon Young-Oh, Lee Won Kee, Lee Yu Rim, Park Soo Young, Tak Won Young대한진단검사의학회 · Annals of Laboratory Medicine2021 · 제41권 제3호만성 B형 및 C형 간염 환자의 간섬유화 진단을 위한 비침습적 혈액 표지자 평가어영, 김주원, 윤갑준, 이종한, 조주영대한진단검사의학회 · Laboratory Medicine Online2019 · 제9권 제3호

이 간행물의 다른 논문 (11건)

임상검사실에서의 액체크로마토그래피-질량분석을 위한 권고안: 제2편. 검사법 검증최현정, 문수영, 박형두, 김세림, 이상국, 이경훈, 송상훈, 이수연pp. 95-108검체 운송 시스템의 온도 유지 기능 평가서소연, 박승만, 함초롱, 권애린, 심효은, 이상곤, 김영진, 김재석pp. 116-124Clinical Utility of Fecal Neutrophil Gelatinase-Associated Lipocalin and Calprotectin as Biomarkers of Clostridioides (Clostridium) difficile Infection윤여민, 이주원, 김한아, 문희원, 허미나pp. 125-131혈장을 이용한 무손상부갑상선호르몬 농도 측정의 유용성 평가: 혈청과의 비교 연구최홍우, 김혜진, 이진경, 김수형, 홍영준, 오애진, 김덕현pp. 132-136Evaluation of Automated Platelet Aggregation Test Using a Sysmex CS-5100 Analyzer한진영, 김경희, 안규대, 우광숙, 김정만, 임현호, 정인화pp. 137-143
원문 보기