Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
Hepatol Int. 2021 Apr;15(2):437-443. doi: 10.1007/s12072-021-10163-0. Epub 2021 Apr 16.
Biochemical response to treatment in patients with primary biliary cholangitis (PBC) reflects prognosis. However, the best predictive criteria to detect biochemical response remain undetermined. In addition, because these criteria need > 6 months until definition, parameters that can estimate its results before initiating treatment are needed.
We conducted a single-center retrospective study on 196 patients with PBC, followed up for at least 12 months after initiating treatment.
Kaplan-Meier analysis showed that Paris II (p = 0.002) and Rotterdam criteria (p = 0.001) could estimate the overall survival of PBC patients, whereas Paris II (p = 0.001), Rotterdam (p = 0.001), and Rochester criteria (p= 0.025) could estimate liver-related deaths. Cox hazard analysis revealed Paris II and Rotterdam criteria as significantly independent predictors of overall survival (hazard ratio (HR) 3.948, 95% CI 1.293-12.054, p = 0.016 and HR 6.040, 95% CI 1.969-18.527, p = 0.002, respectively) and liver-related deaths (HR 10.461, 95% CI 1.231-88.936, p = 0.032 and HR 10.824, 95% CI 1.252-93.572, p = 0.032, respectively). The results of Paris II criteria could be estimated by serum prothrombin time (Odds ratio (OR) 1.052, 95% CI 1.008-1.098, p = 0.021) and alanine transaminase level (OR 0.954, 95% CI 0.919-0.991, p = 0.014) whereas, those of Rotterdam criteria could be estimated by serum albumin level (OR 3.649, 95% CI 1.098-12.128, p = 0.035) at the time of diagnosis.
This study highlights the best prediction criteria and pre-treatment parameters that facilitate the prognosis of PBC patients.
原发性胆汁性胆管炎（PBC）患者的治疗生化反应反映了预后。然而，最佳的预测标准来检测生化反应仍未确定。此外，由于这些标准需要>6 个月才能确定，因此需要在开始治疗之前能够估计其结果的参数。
我们进行了一项单中心回顾性研究，纳入了 196 例 PBC 患者，在开始治疗后至少随访 12 个月。
Kaplan-Meier 分析表明，巴黎 II （p=0.002）和鹿特丹标准（p=0.001）可估计 PBC 患者的总生存率，而巴黎 II （p=0.001）、鹿特丹（p=0.001）和罗彻斯特标准（p=0.025）可估计与肝脏相关的死亡率。Cox 危害分析显示，巴黎 II 标准和鹿特丹标准是总生存率的显著独立预测因素（危害比（HR）3.948，95%CI 1.293-12.054，p=0.016 和 HR 6.040，95%CI 1.969-18.527，p=0.002）和与肝脏相关的死亡率（HR 10.461，95%CI 1.231-88.936，p=0.032 和 HR 10.824，95%CI 1.252-93.572，p=0.032）。巴黎 II 标准的结果可以通过血清凝血酶原时间（比值比（OR）1.052，95%CI 1.008-1.098，p=0.021）和丙氨酸转氨酶水平（OR 0.954，95%CI 0.919-0.991，p=0.014）来估计，而鹿特丹标准的结果可以通过血清白蛋白水平（OR 3.649，95%CI 1.098-12.128，p=0.035）在诊断时进行估计。
本研究强调了最佳预测标准和治疗前参数，有助于预测 PBC 患者的预后。
