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Serum Mac-2-binding protein (M2BPGi) as a marker of chronological liver fibrosis in biliary atresia patients with cirrhosis

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Abstract

Purpose

Biliary atresia (BA) is characterized by progressive liver fibrosis, but it is difficult to assess the progression after the patient develops cirrhosis. Mac-2-binding protein glycosylation isomer (M2BPGi) is a new marker for hepatic fibrosis. We examined the chronological changes in M2BPGi levels in BA patients with cirrhosis.

Methods

Patients with cirrhosis were selected from among pediatric BA patients who had their native livers. Serum M2BPGi levels and Child–Pugh classification were evaluated. A total of 11 pediatric BA patients with cirrhosis were recruited.

Results

Initial M2BPGi level after diagnosis of liver cirrhosis based on liver biopsy was on average 3.4, and the most recent M2BPGi level under observation was on average 4.3. The follow-up period from the initial M2BPGi measurement averaged 22.6 months. The ratio of the initial and most recent values (M2BPGi ratio) was on average 1.3 (0.5–2.4). Three cases with improved fibrosis (M2BPGi ratio < 1.0) remained in Child A, as did six cases (1.0 ≤ M2BPGi ratio < 2.0), but two cases with marked fibrosis progression (2.0 ≤ M2BPGi ratio) advanced to decompensated cirrhosis Child B.

Conclusion

M2BPGi is useful as a prognostic factor for BA patients with liver cirrhosis. In addition, fibrosis improved even after the development of cirrhosis.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan

    Takehisa Ueno, Tasuku Kodama, Yuki Noguchi, Motonari Nomura, Ryuta Saka, Yuichi Takama, Yuko Tazuke & Hiroomi Okuyama

  2. Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Osaka, Japan

    Kazuhiko Bessho

Authors
  1. Takehisa Ueno
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  2. Tasuku Kodama
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  3. Yuki Noguchi
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  4. Motonari Nomura
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  5. Ryuta Saka
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  6. Yuichi Takama
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  7. Yuko Tazuke
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  8. Kazuhiko Bessho
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  9. Hiroomi Okuyama
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Correspondence to Takehisa Ueno.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Ueno, T., Kodama, T., Noguchi, Y. et al. Serum Mac-2-binding protein (M2BPGi) as a marker of chronological liver fibrosis in biliary atresia patients with cirrhosis. Pediatr Surg Int 35, 1065–1070 (2019). https://doi.org/10.1007/s00383-019-04535-9

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