• Miwa Kawanaka, Yasuyuki Tomiyama, Hideyuki Hyogo, Masahiko Koda, Toshihide Shima, Hiroshi Tobita, Akira Hiramatsu, Ken Nishino, Toshiaki Okamoto, Shuichi Sato, Yuichi Hara, Sohji Nishina, Hirofumi Kawamoto, Kazuaki Chayama, Takeshi Okanoue, and Keisuke Hino.
• Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama.
• Hepatol Res. 2018 Jun 1; 48 (7): 521-528.

AimAs it is not practical to perform regular screening for hepatocellular carcinoma (HCC) in all patients with non-alcoholic fatty liver disease (NAFLD), there is a need to identify NAFLD patients who are at high risk for HCC. Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA+ -M2BP) has been shown to be a surrogate marker for predicting HCC as well as a liver fibrosis marker in patients with chronic hepatitis B and C. The aim of this study was to investigate whether WFA+ -M2BP predicts HCC development in NAFLD patients.MethodsSerum WFA+ -M2BP was retrospectively measured in 331 patients with histologically proven NAFLD, 51 of whom developed HCC. The association of WFA+ -M2BP and HCC development in NAFLD patients was investigated.ResultsThe WFA+ -M2BP values were significantly greater in NAFLD patients with HCC than in those without HCC among patients with liver fibrosis ≥stage 3. Multivariate analysis identified WFA+ -M2BP as one of the predictive factors for HCC development (odds ratio, 1.57; 95% confidence interval, 1.083-2.265; P = 0.017). The optimal cut-off index of WFA+ -M2BP for predicting HCC was 1.255 with specificity of 78.4% and sensitivity of 70.4%. The area under the receiver operating characteristic curve value for the prediction of HCC development was 0.806. The cumulative incidence rate of HCC was significantly greater in patients with WFA+ -M2BP ≥ 1.255 (n = 61) than in those with WFA+ -M2BP < 1.255 (n = 137) among patients who were followed up for more than 2 years after the diagnosis of NAFLD.ConclusionsWisteria floribunda agglutinin-positive Mac-2 binding protein predicts HCC development and is a useful surrogate marker for identifying NAFLD patients who are at a high risk for HCC.© 2018 The Japan Society of Hepatology.

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