https://www.ncbi.nlm.nih.gov/pubmed/29168311

Primary sclerosing cholangitis

Hepatol Res. 2017 Nov 22. doi: 10.1111/hepr.13004. [Epub ahead of print]
Umetsu S, Inui A, Sogo T, Komatsu H, Fujisawa T.

Abstract

BACKGROUND:
Wisteria floribunda agglutinin positive Mac-2 binding protein (WFA+ -M2BP) is a novel serum marker of hepatic fibrosis in adults with chronic hepatitis C. However, it remains unclear whether serum WFA+ -M2BP levels are associated with the progression of liverhistology in primary sclerosing cholangitis (PSC) .

METHODS:
Twenty-eight children and adolescence with pediatric onset-PSC (M/F = 20/8, median age at diagnosis: 9 years) were enrolled in this study. The relation between serum WFA+ -M2BP levels and clinical characteristics was retrospectively evaluated. Moreover, receiver operating characteristic (ROC) analysis was performed to determine whether serum WFA+ -M2BP levels could be a reliable marker to identify PSC patients with advanced liver histology.

RESULTS:
According to Ludwig classification of liver histological stage, twenty-eight patients were classified into the 4 stages. WFA+ -M2BP, AST to platelet ratio index (APRI) and hyaluronic acid correlated significantly with liver histological stage. Moreover, WFA+ -M2BP showed a significant positive correlation (p<0.05) with autoimmune hepatitis overlap, AST, ALT, γ-GTP, total bilirubin, IgG, APRI and hyaluronic acid. ROC analysis was performed to distinguish the patients with advanced stage (stage 3 and 4) from those with the early stage (stage 0, 1 and 2). WFA+ -M2BP yielded the highest area under the ROC curve value (0.898) among 4 surrogate makers (APRI: 0.850, Fib-4 index: 0.806, AST/ALT ratio: 0.802). Moreover, WFA+-M2BP yielded the highest sensitivity, specificity, positive predict value and negative predict value among the four markers.

CONCLUSIONS:
Serum WFA+ -M2BP levels are useful to identify patients with advanced liver histology in pediatric PSC.
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KEYWORDS:
Fibrosis; M2BPGi; autoimmune hepatitis; children; liver biopsy