Doan TH, Nguyen KM, Nguyen XV, Pham ATN, Le ND. Evaluating thresholds of Mac-2 binding protein glycosylation isomer in association with clinical outcomes in patients with cirrhosis. World J Hepatol 2025; 17(9): 109179 [DOI: 10.4254/wjh.v17.i9.109179]
Corresponding Author of This Article
Nhan Duc Le, MD, PhD, Intensive Care Unit, Danang Hospital, 124 Hai Phong, Hai Chau, Danang 50000, Viet Nam. drnhandanang@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Sep 27, 2025; 17(9): 109179 Published online Sep 27, 2025. doi: 10.4254/wjh.v17.i9.109179
Evaluating thresholds of Mac-2 binding protein glycosylation isomer in association with clinical outcomes in patients with cirrhosis
Trung Hieu Doan, Khue Minh Nguyen, Xung Van Nguyen, Anh Thi Ngoc Pham, Nhan Duc Le
Trung Hieu Doan, Xung Van Nguyen, Department of Gastroenterology, Danang Hospital, Danang 50000, Viet Nam
Khue Minh Nguyen, Department of Genetics, Ho Chi Minh University of Science, Ho Chi Minh City 700000, Viet Nam
Khue Minh Nguyen, Department of Scientific Affairs, Sysmex Vietnam, Ho Chi Minh City 700000, Viet Nam
Anh Thi Ngoc Pham, Department of Laboratory, Danang Hospital, Danang 50000, Viet Nam
Nhan Duc Le, Intensive Care Unit, Danang Hospital, Danang 50000, Viet Nam
Co-first authors: Trung Hieu Doan and Khue Minh Nguyen.
Author contributions: Doan TH and Nguyen KM contributed to the design of the study, revised the collected data, performed the statistical data analysis and interpretation, and reviewed and provided the final version of the manuscript; Nguyen XV and Pham ATN shared the operational work of the study and the writing of the manuscript; Doan TH and Nguyen XV recruited participants and collected data; Le ND supervised the study; Doan TH and Nguyen KM contributed equally to this study and merit co-first authorship; all authors contributed to revision of the manuscript for important intellectual content and approved the final version.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Da Nang Hospital (No. 2022.11.54 issued in March 2022).
Informed consent statement: Informed consent was waived for this study based upon the utilization of residual blood samples.
Conflict-of-interest statement: Khue Minh Nguyen is a Sysmex employee. All other authors declare no conflicts of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nhan Duc Le, MD, PhD, Intensive Care Unit, Danang Hospital, 124 Hai Phong, Hai Chau, Danang 50000, Viet Nam. drnhandanang@gmail.com
Received: May 8, 2025 Revised: June 28, 2025 Accepted: August 21, 2025 Published online: September 27, 2025 Processing time: 141 Days and 5.4 Hours
Abstract
BACKGROUND
Cirrhosis is a progressive condition characterized by fibrosis that can lead to severe complications and increased mortality. The mac-2 binding protein glycosylation isomer (M2BPGi) is a prominent biomarker for predicting hepatocellular carcinoma (HCC) and cirrhosis-induced esophageal varices (EV).
AIM
To investigate thresholds of M2BPGi associated with HCC, EV, and decompensation in patients with cirrhosis.
METHODS
This was a prospective study. A total of 153 patients with cirrhosis who met the inclusion criteria were enrolled. The patients were diagnosed with HCC and EV according to the Baveno VII and European Association for the Study of the Liver guidelines. Baseline serum M2BPGi levels were assessed along with other routine tests. The data analysis aimed to determine the cutoff values of M2BPGi for predicting EV and HCC.
RESULTS
In the study 85.6% of patients were Child-Pugh B and C. M2BPGi mean cutoff index was 7.1 ± 3.7, showing no significant etiological differences. However, M2BPGi levels varied significantly among Child-Pugh classes, EV classifications, and between patients with and without HCC (P < 0.01). M2BPGi cutoff values for predicting HCC, EV, and decompensated cirrhosis were 6.50, 6.64, and 5.25, respectively. Multivariate analysis confirmed M2BPGi as an independent risk factor for EV [adjusted odds ratio (aOR): 1.3, 95%CI: 1.08-1.64] and liver decompensation (aOR: 2.11, 95%CI: 1.37-3.83). Area under the curve of M2BPGi for HCC differentiation was 0.71. An algorithm combining alpha-fetoprotein (AFP) and M2BPGi detected 26 of 28 HCC cases with 98.04% accuracy vs 10 cases by AFP alone.
CONCLUSION
Serum M2BPGi predicted cirrhosis complications, including decompensation and varices, especially in HCC. Combined with AFP, it enhanced HCC detection. Future liver biopsy studies are needed for tissue confirmation.
Core Tip: This study introduces serum mac-2 binding protein glycosylation isomer (M2BPGi) as a novel biomarker for predicting complications in cirrhotic patients, particularly hepatocellular carcinoma (HCC), liver decompensation, and esophageal varices. The findings show that combining M2BPGi with alpha-fetoprotein significantly enhances diagnostic accuracy, achieving an impressive sensitivity of 92.8% for HCC detection. Importantly, M2BPGi levels correlate with disease severity as measured by the Child-Pugh classification, highlighting its potential role in clinical risk stratification.
