Serum Wisteria Floribunda Agglutinin-positive Mac-2-binding Protein Predicts Liver Function And Prognosis In Liver Cirrhosis

Background:Mac-2-binding protein(M2BP)is a secreted N-glycoprotein.Wisteria floribunda agglutinin(WFA)could bind to M2BP to form Wisteria floribunda agglutinin-positive Mac-2 binding protein(WFA~+-M2BP).Previous studies have demonstrated that serum WFA~+-M2BP levels are significantly correlated with the degree of liver fibrosis and predict the development of hepatocellular carcinoma(HCC)and the efficacy of both anti-HBV and anti-HCV drugs.However,few studies have identified its relationship with liver function reserve and prognosis in liver cirrhosis patients.Aim:To identify the role of WFA~+-M2BP in predicting liver function and prognosis of patients with liver cirrhosis.Methods:The present study retrospectively included 197 patients with liver cirrhosis between 2013 and 2016.With a median of 23 months follow-up period,clinical events and prognosis of 160 patients were recorded.Serum WFA~+-M2BP and various biochemical parameters were measured in all patients.Serum WFA~+-M2BP level was directly measured with the HISCL?M2BPGi reagent(Sysmex.,Kobe,Japan)using a fully automatic immunoassay machine(HISCL-2000i;Sysmex).The accuracy of WFA~+-M2BP in evaluating liver function reserve,predicting decompensation and mortality were analyzed by receiver operating characteristic curve(ROC)analysis,logistic regression analysis and Cox regression analysis,respectively.Results:Among the 197 included patients,serum WFA~+-M2BP levels were increased with the upgrading of Child-Pugh class,especially in patients with hepatitis B virus(HBV)infection.ROC analysis confirmed the high reliability of WFA~+-M2BP for the assessment of liver function evaluated by Child-Pugh classification.WFA~+-M2BP was also significantly positively correlated with model for end-stage liver disease(MELD)scores.More importantly,multivariate logistic regression analysis indicated WFA~+-M2BP as an independent predictor of clinical decompensation for compensated patients(OR=11.958;95%CI:1.876-76.226;P=0.009),and multivariate Cox's regression analysis verified WFA~+-M2BP as an independent risk factor for liver-related death in patients(HR=2.57;95%CI:1.013-6.525;P=0.047).Conclusion:Serum WFA~+-M2BP is a reliable predictor of liver function and prognosis of patients with liver cirrhosis and could be incorporated into clinical surveillance strategies for cirrhotic patients,especially those with HBV infection.