Wisteria floribunda agglutinin-positive Mac-2 binding protein predicts early occurrence of hepatocellular carcinoma after sustained virologic response by direct-acting antivirals for hepatitis C virus
Yutaka Yasui
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorMasayuki Kurosaki
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorYasuyuki Komiyama
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
First Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan
Search for more papers by this authorHitomi Takada
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
First Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan
Search for more papers by this authorNobuharu Tamaki
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorKeiya Watakabe
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorMao Okada
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorWan Wang
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorTakao Shimizu
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorYohei Kubota
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorMayu Higuchi
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorKenta Takaura
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorKaoru Tsuchiya
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorHiroyuki Nakanishi
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorYuka Takahashi
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorJun Itakura
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorNobuyuki Enomoto
First Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan
Search for more papers by this authorCorresponding Author
Namiki Izumi
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Correspondence: Dr Namiki Izumi, Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, 1-26-1 Kyonan-cho, Musashino-shi, Tokyo 180-8610, Japan. Email: [email protected]Search for more papers by this authorYutaka Yasui
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorMasayuki Kurosaki
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorYasuyuki Komiyama
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
First Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan
Search for more papers by this authorHitomi Takada
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
First Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan
Search for more papers by this authorNobuharu Tamaki
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorKeiya Watakabe
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorMao Okada
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorWan Wang
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorTakao Shimizu
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorYohei Kubota
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorMayu Higuchi
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorKenta Takaura
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorKaoru Tsuchiya
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorHiroyuki Nakanishi
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorYuka Takahashi
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorJun Itakura
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Search for more papers by this authorNobuyuki Enomoto
First Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan
Search for more papers by this authorCorresponding Author
Namiki Izumi
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Correspondence: Dr Namiki Izumi, Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, 1-26-1 Kyonan-cho, Musashino-shi, Tokyo 180-8610, Japan. Email: [email protected]Search for more papers by this authorConflict of interest: The authors have no conflict of interest.
Financial support: This study was supported by a grant-in aid from the Japan Agency for Medical Research and Development (grant no. 15fk0210007h0002).
Abstract
Aim
The aim of this study is to clarify the value of serum Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA+-M2BP) for predicting hepatocellular carcinoma (HCC) in chronic hepatitis C patients who achieved sustained virologic response (SVR) by therapy with interferon-free, direct-acting antivirals (DAAs).
Methods
This is a retrospective cohort study that included 567 patients who underwent antiviral therapy with an interferon-free DAA regimen and achieved SVR. Serum WFA+-M2BP was measured after SVR. Factors predictive of HCC occurrence and recurrence were analyzed in the patients after stratification by previous treatment history of HCC.
Results
Among 518 patients who had no history of HCC, 13 developed HCC. Post-SVR WFA+-M2BP ≥1.75 cut-off index (C.O.I., P < 0.001) and α-fetoprotein (AFP) level ≥6 ng/mL (P = 0.01) were significant predictors of HCC development. Multivariate analysis showed that post-SVR WFA+-M2BP ≥1.75 C.O.I. was an independent factor significantly associated with the development of HCC (hazard ratio [HR] 6.0; 95% confidence interval (CI), 1.8–19.4; P = 0.003). Among 49 patients who had a previous history of HCC, 22 had recurrence after SVR. Post-SVR AFP ≥6 ng/mL was the only factor associated with recurrence-free survival (HR 3.1; 95% CI, 1.3–7.5; P = 0.01).
Conclusions
Post-SVR WFA+-M2BP is a predictive factor for the development of HCC in patients with no previous HCC history and treated with DAAs. Post-SVR AFP was predictive for HCC recurrence after DAA therapy.
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