Serum wisteria floribunda agglutinin-positive human Mac-2 binding protein is unsuitable as a diagnostic marker of occult hepatocellular carcinoma in end-stage liver cirrhosis

by Kantoku Nagakawa, Masaaki Hidaka, Takanobu Hara, Hajime Matsushima, Hajime Imamura, Takayuki Tanaka, Tomohiko Adachi, Akihiko Soyama, Kengo Kanetaka, Susumu Eguchi

Serum glycosylated Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA⁺-M2BP) is a marker of liver fibrosis and hepatocellular carcinoma (HCC). In this study, we aimed to evaluate the diagnostic ability of WFA⁺-M2BP for occult HCC, which current diagnostic imaging tests fail to detect.

Patients who underwent hepatectomy for liver transplantation (LT) and whose whole liver could be sliced and subjected to histological examination between 2010 and 2018 were eligible for this study (n = 89). WFA⁺-M2BP levels were measured in samples collected before the LT. Comparison of the postoperative histological test results with the preoperative imaging data grouped the patients into histologically no group (N), histologically detected group (D), histologically increased group (I), and histologically decreased or same group (DS), and the results were compared with the WFA⁺-M2BP values. In addition, comparisons were made between each data with and without HCC, including occult HCC, and total tumor diameter.

Irrespective of underlying hepatic disease conditions, there were 6 patients in the N group, 10 in the D group, 41 in the I group, and 32 in the DS group. The median of the serum WFA⁺-M2BP level for each group was as follows: N group, 8.05 (1.25–11.9); D group, 11.025 (1.01–18.21); I group, 9.67 (0.29–17.83); and DS group, 9.56 (0.28–19.44) confidence of interval. We found no significant differences between the pairings. Comparison of underlying hepatic diseases revealed that liver cirrhosis due to hepatitis B and C and non-B and -C liver cirrhosis had no significant differences. AFP levels, on the other hand, had significant relationships in comparison between the presence or absence of histological HCC, in correlation between total tumor diameter, and in the ROC analysis for the diagnosis of HCC including occult HCC.

Serum WFA⁺-M2BP cannot help diagnose occult HCC that is already undetected using imaging tests in decompensated liver cirrhosis patients requiring LT.