Serum WFA+-M2BP levels as a prognostic factor in patients with early hepatocellular carcinoma undergoing curative resection

Background & Aims: Serum tumour markers for hepatocellular carcinoma (HCC) have less prognostic significance in early stage. Serum Wisteria floribunda agglutinin-positive Mac-2-binding protein (WFA(+)-M2BP) levels are reportedly associated with hepatocarcinogenic potential in patients with chronic liver diseases. We investigated the prognostic significance of pre-treatment serum WFA(+)-M2BP levels in patients with early-stage HCC. Methods: A total of 240 patients who underwent hepatic resection for na_ ive Barcelona Clinic Liver Cancer (BCLC) class 0 or A HCC were analysed. WFA(+)-M2BP and tumour markers for HCC were measured from serum obtained just prior to treatment. Post-operative recurrence and survival rates were compared according to these serum markers, tumour stage and Child-Pugh class. Results: There was an association between serum WFA(+)-M2BP levels and the fibrosis grade of resected noncancerous liver tissue, whereas no association was found between WFA(+)-M2BP levels and tumour progression or liver function. In a multivariate analysis, pretreatment serum WFA(+)-M2BP level was associated with recurrence and survival, respectively, independent of HCC progression or fibrosis grade of resected noncancerous liver tissue. Recurrence rates after hepatic resection were significantly higher in patients with a pretreatment serum WFA(+)-M2BP >= 3.00 than those with a pretreatment serum WFA(+)-M2BP < 3.00 (P = 0.0038). Survival rates were lower in patients with a pretreatment serum WFA(+)-M2BP = 3.00 than those with a pretreatment serum WFA(+)-M2BP < 3.00 (P = 0.0187). Conclusions: Serum WFA(+)-M2BP level is a prognostic factor for recurrence and survival, in addition to tumour progression and liver function, in patients with early-stage HCC treated with curative hepatic resection.