Serum Mac-2-binding protein glycosylation isomer and risk of hepatocellular carcinoma in entecavir-treated chronic hepatitis B patients.

BACKGROUND AND AIM: Hepatocellular carcinoma (HCC) can still develop in chronic hepatitis B (CHB) patients receiving antiviral treatment. Serum Mac-2-binding protein glycosylation isomer (M2BPGi) is a novel marker for liver fibrosis. We investigated its role on incidence of HCC in entecavir (ETV)-treated CHB patients. METHODS: We identified HCC cases diagnosed at ≥ 1 year of ETV treatment. CHB patients without HCC (matched for age, gender, baseline hepatitis B virus-DNA, and duration of ETV treatment) were identified in approximately 1:2 ratio (HCC: non-HCC) for comparison. Serum samples were retrieved at baseline (initiation of ETV), 3, and 5 years of ETV for serum M2BPGi measurement (expressed in cut-off index [COI]). RESULTS: One hundred HCC cases were matched with 185 CHB patients without HCC (median age 56.7 years, 78.9% male, baseline hepatitis B virus-DNA 5.6 logIU/mL, and median follow-up 7.1 years). Median time from ETV initiation to incident HCC was 3.9 years. Serum M2BPGi levels were significantly higher in HCC cases compared with controls at baseline and year 3 (1.25 vs 0.98 [P = 0.004], 0.89 vs 0.74 [P = 0.018] COI, respectively). Multivariate analysis showed that baseline M2BPGi was the only independent factor associated with incident HCC (odds ratio 1.241, 95% confidence interval 1.039-1.482, P = 0.017). Using a cut-off value of 1.15 COI, the sensitivity, specificity, positive predictive value, and negative predictive value of baseline serum M2BPGi in cirrhotic patients to predict incident HCC were 90%, 53.8%, 69.6%, and 82.1%, respectively. CONCLUSIONS: Baseline and 3-year serum M2BPGi may be useful to identify high risk patients on antiviral treatment for subsequent HCC development.

The 100 most cited manuscripts in coronary artery bypass grafting.

INTRODUCTION: To gain a better understanding of the progression of coronary artery bypass grafting (CABG) and its impact on clinical practice, bibliometric citation analysis can be performed. Bibliometric citation analysis is a method of determining the most influential papers on a topic based on several citations and impact factor. METHOD: A search of the Thomson Reuters Web of Science citation indexing database and research platform was completed using the terms "CABG," "Coronary artery bypass graft," "Coronary artery," "bypass," and/or "bypass grafting." The returned dataset was sorted by the number of citations. RESULTS: The search yielded a total of 11 560 papers which were ranked in order of citations. New England Journal of Medicine published the most papers in the top 100 and generated the most significant number of citations with 20 papers in total followed by Journal of the American College of Cardiology. It also has the highest impact factor and 5-year impact fact in 2007 of 79.26 and 67.513, respectively. CONCLUSION: The most cited manuscripts by Serruys et al described a randomised trial comparing percutaneous coronary intervention and CABG for treating severe coronary artery disease. This work provides the most influential references related to CABG and serves as a guide as to the area of focus in CABG.