Mac-2 Binding Protein Glycosylation Isomer for Screening High-Risk Esophageal Varices in Liver Cirrhotic Patient

Abstract

Background: Esophageal varices occur at middle to advanced stages of cirrhosis and are associated with increased mortality due to their potential for rupture and bleeding. The aim of this study is to examine the accuracy of a surrogate marker, Mac-2 binding protein glycosylation isomer (M2BPGi), for screening high-risk esophageal varices in cirrhotic patients. Methods: Ninety-four cirrhotic patients who underwent endoscopy screening at Cipto Mangunkusumo Hospital, Jakarta, Indonesia were included. Patients with a history of ligation, portal vein thrombosis, or hepatocellular carcinoma were excluded. All enrolled patients underwent ultrasonography, transient elastography, and laboratory tests. The HISCL-5000 Sysmex analyzer was used to measure M2BPGi levels. Results: Of these 94 patients, 27 had high-risk esophageal varices and 67 had non-high-risk esophageal varices. M2BPGi levels were higher in patients with high-risk esophageal varices compared with those with non-high-risk esophageal varices (cutoff index (COI) of 11.4 vs. 3.7, p < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of M2BPGi with a cutoff value of 5 COI was 92.6%, 70.1%, 55.6%, and 95.9%, respectively. Conclusions: M2BPGi could be used as a non-invasive surrogate marker for ruling out high-risk esophageal varices in cirrhotic patients. This method is cheap and non-invasive and could be used as a screening tool in resource-limited settings.

Cyclic GMP in Liver Cirrhosis—Role in Pathophysiology of Portal Hypertension and Therapeutic Implications

“…Several biochemical parameters in liver cirrhosis indicate hepatocyte damage or cholestasis, while others indicate stimulated synthesis of extracellular matrix proteins (laminin, hyaluronic acid, procollagen-III-peptide, Mac-2-binding protein glycosylation isomer) by stimulated HSCs (myofibroblasts), thus reflecting the degree of liver fibrosis. Various serum markers are suitable tools to detect clinically significant portal hypertension [ 119 , 120 , 121 , 122 , 123 ].…”

Correlation of Mac-2 Binding Protein Glycosylation Isomer (M2BPGi) with Liver Transient Elastography Results in Evaluating Liver Fibrosis in Chronic Hepatitis B Patients

“…[26][27][28][29] Recent studies on M2BPGi in Indonesia focused on the accuracy of M2BPGi in chronic hepatitis C patients and screening of high-risk oesophagal varices in patients with liver cirrhosis, whereas in chronic hepatitis B patients, there were only evidence-based case reports. 28,30,31 This report concluded that M2BPGi could not be used as a diagnostic modality to detect liver fibrosis in chronic hepatitis B patients, because the sensitivity and specificity from these four studies showed that the M2BPGi are still insufficient to detect and rule out liver fibrosis in chronic hepatitis B patients. The difference in the cut-off value of M2BPGi to determine the stage of fibrosis in each study means that this value cannot be directly used as an accurate standard for determining advanced (F ≥ 3) liver fibrosis.…”

M2BPGi for Liver Fibrosis Assessment in Chronic Liver Diseases in Indonesia

“…Previous study showed that among cirrhotic patients in Indonesia, M2BPGi measurement can be used to rule out high risk varices with negative predictive value > 90%. 4 Furthermore, considering the rising prevalence of metabolic associated-fatty liver disease (MAFLD) in Indonesia, it is also important to evaluate the diagnostic performance of M2BPGi level in CHB patients with MAFLD. Further studies on the role of M2BPGi and the factors that influence its performance will provide valuable insight into liver fibrosis and chronic liver diseases.…”