Ann Lab Med 2018; 38(4): 348-354  https://doi.org/10.3343/alm.2018.38.4.348
Diagnosis of Liver Fibrosis With Wisteria floribunda Agglutinin-Positive Mac-2 Binding Protein (WFA-M2BP) Among Chronic Hepatitis B Patients
Dong Wook Jekarl, M.D.1,6, Hyunyu Choi, B.S.1, Seungok Lee, M.D.1,6, Jung Hyun Kwon, M.D.2, Sung Won Lee, M.D.3, Hein Yu, M.T.4, Myungshin Kim, M.D.4,6, Yonggoo Kim, M.D.4,6, Pil Soo Sung, M.D.5, and Seung Kew Yoon, M.D.5
Departments of Laboratory Medicine1 and Internal Medicine2, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul; Department of Internal Medicine3, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul; Departments of Laboratory Medicine4 and Internal Medicine5, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul; Laboratory for Development and Evaluation Center6, College of Medicine, The Catholic University of Korea, Seoul, Korea
Corresponding author: Yonggoo Kim
Department of Laboratory Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea
Tel: +82-2-2258-1642
Fax: +82-2-2285-1917
E-mail: yonggoo@catholic.ac.kr
Co-corresponding author: Seung Kew Yoon
Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 06591, Korea
Tel: +82-2-2258-7534
Fax: +82-2-536-9559
E-mail: yoonsk@catholic.ac.kr
Received: June 6, 2017; Revised: November 3, 2017; Accepted: February 27, 2018; Published online: July 1, 2018.
© Korean Society for Laboratory Medicine. All rights reserved.

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Abstract
Background: Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA-M2BP) is a protein with altered glycosylation that reacts with lectin, and was recently identified as a useful non-invasive biomarker for the diagnosis of liver fibrosis in patients with hepatitis C virus infection.This study aimed to evaluate the diagnostic efficacy of WFA-M2BP for liver fibrosis in the context of hepatitis B virus (HBV).
Methods: We enrolled 151 patients infected with HBV. Liver biopsy and elastography (Fibroscan) were performed during the initial visit. Fibrosis was graded according to the Knodell histologic activity index (F0–3). WFA-M2BP levels were determined with an automated immunoassay analyzer (M2BPGi, HISCL-5000, Sysmex, Japan). The diagnostic efficacy of WFA-M2BP was compared with those of various conventional or composite biomarkers, including enhanced liver fibrosis (ELF) score, Fibroscan, aspartate transaminase (AST)-to-platelet ratio index (APRI), and FIB-4, based on the area under the ROC curve (AUC) value.
Results: The majority of patients were at fibrosis stages F1 and F2. The F2 and F3 AUC values for WFA-M2BP were similar to those for FIB-4, APRI, ELF, and Fibroscan, although the latter showed the best diagnostic efficacy. The diagnostic accuracy of all tested biomarkers for F2 and F3 was 60–70%. In multivariate analysis, WFA-M2BP, ELF, and platelet count significantly predicted stage ≥F2, whereas only platelet count significantly predicted F3.
Conclusions: WFA-M2BP can support a diagnosis of liver fibrosis with similar diagnostic efficacy to other biomarkers, and predicted liver fibrosis stage ≥2 among patients with chronic hepatitis B.
Keywords: Liver Fibrosis, Hepatitis B, Wisteria floribunda agglutinin-positive Mac-2 binding protein, Diagnosis, Efficacy



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