MeCP2 level is associated with hepatocellular carcinoma development in chronic hepatitis B patients under antiviral therapy

Aim: Hepatocellular carcinoma (HCC) is a common and aggressive malignant tumor with especially high prevalence in Asia. This present study aimed to investigate the association of MeCP2 with HCC development in patients with undetectable HBV DNA by antiviral therapy. Methods: We retrospectively reviewed the 258 patients that were recruited into the present study. The control patients were matched with the HCC patients by age, gender, hepatitis e antigen (HBeAg) status, and duration of NA therapy in a 1: 1: 1 ratio. Area under ROC curve (AUC) was also used to compare diagnostic significance of MeCP2 using the Hanley and McNeil method. Results: For the entire cohort of 258 patients, MeCP2 was overexpressed in HCC tissues, which was significantly higher than that in cirrhosis and non-cirrhosis tissues (P<0.001). MeCP2 significantly increased in HCC cell lines compared with the control group of THLE-2 including SMMC-7721 (P<0.001), Huh-7 (P<0.001), and Hep3B (P<0.001). Overexpression of MeCP2 was closely related to liver cirrhosis (P=0.001) and TNM stage (P=0.017). The AUROC for the entire cohort, cirrhotic patients and non-cirrhotic patients, was 0.741 (95% CI: 0.629-0.804), 0.682 (95% CI: 0.526-0.782), and 0.776 (95% CI: 0.646-0.903), respectively. The predictive accuracies of MeCP2 in different groups of patients were further compared. For the whole cohort, this test had a high specificity in identifying patients without HCC development (85%). Among patients without cirrhosis, this test had a high sensitivity in identifying patients with future HCC development (83%). Conclusions: We found that MeCP2 was expressed significantly higher in HCC tissues compared with cirrhosis and non-cirrhosis tissues. MeCP2 could be a novel risk marker to predict HCC development in CHB patients with profound viral suppression under NA therapy. MeCP2 measurement may serve as a useful strategy for risk stratification in terms of follow up interval and HCC surveillance.