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Clinicopathological characteristics and diagnostic performance of Wisteria floribunda agglutinin positive Mac-2-binding protein as a preoperative serum marker of liver fibrosis in hepatocellular carcinoma

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Wisteria floribunda agglutinin positive Mac-2-binding protein (WFA+-M2BP) is a novel serum marker of liver fibrosis identified in glycoproteomic biomarker screening studies, and its clinicopathological characteristics have yet to be elucidated sufficiently for clinical utilization.


We retrospectively analyzed the clinicopathology data and serum WFA+-M2BP levels in 376 hepatocellular carcinoma patients undergoing liver surgery. WFA+-M2BP was quantified in frozen serum samples collected at the time of surgery using the FastLec-Hepa method.


Significant independent determinants of serum WFA+-M2BP levels included pathological diagnosis of cirrhosis, female gender, hepatitis C virus (HCV) infection, and liver dysfunction characteristics, such as abnormal indocyanine green retention rate at 15 min, platelet counts, albumin levels, alanine aminotransferase levels, and total bilirubin levels. Serum WFA+-M2BP levels increased with the pathological fibrosis stage and liver dysfunction severity. HCV infection significantly affected serum WFA+-M2BP levels throughout the pathological and functional progression of liver fibrosis, and the effect of gender was significant only in F4 stage patients with severe liver dysfunction. The diagnostic thresholds for cutoff index values for cirrhosis were 1.435 and 4.615 in HCV-negative and HCV-positive patients, respectively. Serum WFA+-M2BP levels at the time of operation were a significant predictor of hepatocellular carcinoma recurrence and overall survival in both HCV-negative and HCV-positive patients.


Serum WFA+-M2BP levels reflected both the pathological and functional progression of liver fibrosis comprehensively and continuously. Elevated WFA+-M2BP levels were a significant risk factor for tumor recurrence and decreased overall survival after liver surgery independent of HCV infection.

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Alpha fetoprotein


Lens culinaris agglutinin reactive fraction of alpha fetoprotein


Alanine aminotransferase


Cutoff index


Hepatitis B virus


Hepatocellular carcinoma


Hepatitis C virus


Indocyanine green retention rate at 15 min


Mac-2-binding protein


Protein induced by vitamin K absence II


Wisteria floribunda agglutinin


Wisteria floribunda agglutinin positive Mac-2-binding protein


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The authors are grateful for the assistance of the Hepatitis Glyco-biomarker Study Group. This study was supported by a grant-in-aid from the Ministry of Health, Labour and Welfare, Japan.

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The authors declare that they have no conflict of interest.

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Correspondence to Akinobu Taketomi.

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Fujiyoshi, M., Kuno, A., Gotoh, M. et al. Clinicopathological characteristics and diagnostic performance of Wisteria floribunda agglutinin positive Mac-2-binding protein as a preoperative serum marker of liver fibrosis in hepatocellular carcinoma. J Gastroenterol 50, 1134–1144 (2015).

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