Mac-2 binding protein glycosylation isomer as a novel serum biomarker for recurrence in hepatocellular carcinoma.

Abstract

<h4>Background</h4>Accurate prediction of hepatocellular carcinoma (HCC) recurrence after curative therapy remains challenging. Mac-2 binding protein glycosylation isomer (M2BPGi), a serum marker of liver fibrosis, may serve as a noninvasive prognostic biomarker.<h4>Aim</h4>To evaluate the association between preoperative M2BPGi levels and HCC recurrence following curative treatment.<h4>Methods</h4>We searched PubMed Cochrane CENTRAL, EMBASE, and BIOSIS Citation Index for English-language studies in humans reporting HCC recurrence outcomes stratified by high <i>vs</i> low serum M2BPGi. Four retrospective studies (total <i>n</i> = 494) met inclusion criteria for meta-analysis. Data on recurrence-related survival (recurrence-free, tumor-free, or progression-free survival) and unadjusted and/or adjusted hazard ratios (HR) for high <i>vs</i> low M2BPGi were extracted. Random-effects meta-analyses were performed separately for univariate and multivariate HRs. Heterogeneity was assessed by <i>I</i> ² and publication bias by Egger's test.<h4>Results</h4>High preoperative M2BPGi was significantly associated with increased recurrence risk. The pooled unadjusted HR was 2.98 (95%CI: 1.50-5.91; <i>P</i> < 0.01; <i>I</i> ² = 38.3%), and the pooled adjusted HR was 2.22 (95%CI: 1.48-3.32; <i>P</i> < 0.01; <i>I</i> ² = 0%). Meta-regression showed no effect of varying cutoff thresholds on HRs, and Egger's tests indicated no evidence of publication bias in the multivariate results. The bias-corrected estimated of the univariate HR remained statistically significant (HR = 2.31, 95%CI: 1.21-4.41, <i>P</i> = 0.021, <i>I</i> ² = 32%).<h4>Conclusion</h4>Preoperative serum M2BPGi is a promising biomarker for HCC recurrence after hepatectomy. Its strong association with risk, minimal heterogeneity across studies, and ease of measurement support its potential clinical utility.