Wang Zhongfeng, Liu Xu, Xu Hongqin, Qu Limei, Zhang Dezhi, Gao Pujun
Department of Hepatology Department of Pathology Department of Abdomen Ultrasound, the First Hospital of Jilin University, Jilin University, Xinmin Street, Changchun, China.
Medicine (Baltimore). 2018 Feb;97(7):e9843. doi: 10.1097/MD.0000000000009843.
The aim of this study was to evaluate the ability of noninvasive markers to identify the histological severity of primary biliary cholangitis (PBC).Fifty-eight treatment-naïve PBC patients who had undergone liver biopsy were enrolled in our study. The patients' histological stages were based on the classifications of Ludwig and Scheuer. Aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis index based on the 4 factors (FIB-4), red blood cell distribution width to platelet ratio (RPR), and platelet count to spleen thickness (PC/ST) ratio were calculated. Using the area under the receiver operating characteristic curve (AUROC) to evaluate the accuracy of different markers for predicting the histological severity.Among the 58 treatment-naïve PBC patients, the patients of Scheuer stage I/II/III/IV were 17/25/11/5, respectively. PC/ST ratio (AUROC = 0.807) was superior to RPR (AUROC = 0.717), APRI (AUROC = 0.726), FIB-4 (AUROC = 0.722), and mean platelet volume (MPV) (AUROC = 0.671) in discriminating between stage I and stage ≥II. The AUROC of PC/ST ratio, RPR, APRI, FIB-4, and MPV were 0.939, 0.872, 0.816, 0.831 and 0.572, respectively, for Scheuer stage ≥III; 0.968, 0.795, 0.744, and 0.723, respectively for stage IV. The sensitivity and specificity of PC/ST ratio were 73.4%,79.1%; 81%,100%;88.7%,100% for detection of Scheuer stage ≥ II, Scheuer stage ≥ III and Scheuer stage IV, respectively.Our study findings indicated that compared with previous noninvasive test PRP, APRI, FIB-4 and MPV, PC/ST ratio shows the most accurate for distinguish the histologic severity of PBC patients.
本研究的目的是评估非侵入性标志物识别原发性胆汁性胆管炎（PBC）组织学严重程度的能力。58例未经治疗且接受过肝活检的PBC患者纳入本研究。患者的组织学分期基于Ludwig和Scheuer分类。计算天冬氨酸转氨酶与血小板比值指数（APRI）、基于4项因子的纤维化指数（FIB-4）、红细胞分布宽度与血小板比值（RPR）以及血小板计数与脾脏厚度比值（PC/ST）。采用受试者工作特征曲线下面积（AUROC）评估不同标志物预测组织学严重程度的准确性。在58例未经治疗的PBC患者中，Scheuer I/II/III/IV期患者分别为17/25/11/5例。在区分I期和≥II期时，PC/ST比值（AUROC = 0.807）优于RPR（AUROC = 0.717）、APRI（AUROC = 0.726）、FIB-4（AUROC = 0.722）和平均血小板体积（MPV）（AUROC = 0.671）。对于Scheuer≥III期，PC/ST比值、RPR、APRI、FIB-4和MPV的AUROC分别为0.939、0.872、0.816、0.831和0.572；对于IV期，分别为0.968、0.795、0.744和0.723。PC/ST比值检测Scheuer≥II期、Scheuer≥III期和Scheuer IV期的灵敏度和特异性分别为73.4%、79.1%；81%、100%；88.7%、100%。我们的研究结果表明，与之前的非侵入性检测PRP、APRI、FIB-4和MPV相比，PC/ST比值在区分PBC患者组织学严重程度方面最为准确。
