Wisteria floribunda agglutinin‐positive human Mac‐2 binding protein predicts the risk of HBV‐related liver cancer development

Background & Aims Wisteria floribunda agglutinin‐positive human Mac‐2 binding protein ( WFA + ‐M2 BP ) can be used to assess the degree of liver fibrosis, but few studies have investigated its prognostic utility. We evaluated whether serum WFA + ‐M2 BP can predict the development of hepatocellular carcinoma ( HCC ) in chronic hepatitis B ( CHB ) patients. Methods A total of 1323 CHB patients with WFA + ‐M2 BP test results between 2009 and 2011 were included in this retrospective analysis. Results The mean age of patients (793 men) was 51.0 years. During the follow‐up period (median 60.3 months), 52 (3.9%) patients developed HCC . Age, the proportion of male gender, the presence of diabetes and cirrhosis, and levels of aspartate aminotransferase, alpha‐foetoprotein, and WFA + ‐M2 BP were significantly greater in patients with HCC than in those without HCC , whereas serum albumin levels and platelet counts were significantly lower in patients with HCC than in those without HCC (all P <.05). In multivariate analysis, WFA + ‐M2 BP level was an independent predictor of HCC development (adjusted hazard ratio 1.143, 95% CI: 1.139‐1.829), along with male gender and diabetes (all P <.05). In patients without cirrhosis (n=1087), WFA + ‐M2 BP levels ≥1.8 were associated with a higher risk of HCC development ( P <.001 by log‐rank test), whereas WFA + ‐M2 BP levels ≥1.8 tended to be associated with a higher risk of HCC development in patients with cirrhosis (n=236) ( P =.073 by log‐rank test). Conclusions WFA + ‐M2 BP level can independently predict HCC development. Further studies should investigate whether WFA + ‐M2 BP level could be incorporated into surveillance strategies for CHB patients.