The risk predictive values of UK-PBC and GLOBE scoring system in Chinese patients with primary biliary cholangitis: the additional effect of anti-gp210

被引:73
作者
Yang, F. [1 ]
Yang, Y. [1 ]
Wang, Q. [1 ]
Wang, Z. [1 ]
Miao, Q. [1 ]
Xiao, X. [1 ]
Wei, Y. [1 ]
Bian, Z. [2 ]
Sheng, L. [1 ]
Chen, X. [1 ]
Qiu, D. [1 ]
Fang, J. [1 ]
Tang, R. [1 ]
Gershwin, M. E. [3 ]
Ma, X. [1 ]
机构
[1] Shanghai Jiao Tong Univ, Div Gastroenterol & Hepatol,Shanghai Inst Digest, Key Lab Gastroenterol & Hepatol,Renji Hosp,Sch Me, Minist Hlth,State Key Lab Oncogenes & Related Gen, Shanghai, Peoples R China
[2] Nantong Univ, Nantong Inst Liver Dis, Nantong Peoples Hosp 3, Dept Gastroenterol & Hepatol, Nantong, Jiangsu, Peoples R China
[3] Univ Calif Davis, Div Rheumatol Allergy & Clin Immunol, Davis, CA 95616 USA
基金
中国国家自然科学基金;
关键词
LONG-TERM PROGNOSIS; BIOCHEMICAL RESPONSE; URSODEOXYCHOLIC ACID; CIRRHOSIS; INFLAMMATION; PROGRESSION; ANTIBODIES; OUTCOMES;
D O I
10.1111/apt.13927
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Adequate risk stratification is critical for the management of the patients with primary biliary cholangitis (PBC). The UK-PBC and GLOBE scoring systems for prognosis of PBC have been proposed recently, but have not been validated in Asian population. Aim To validate the UK-PBC and GLOBE scoring systems in Chinese patients for prognosis of PBC. To clarify the role of anti-gp210 as a biomarker, and to investigate whether anti-gp210 could affect the prognostic values of UK-PBC and GLOBE scoring systems. MethodsWe retrospectively analysed 276 patients with PBC evaluated between September 2004 and May 2016, including 133 anti-gp210+ and 143 anti-gp210- patients. Results The 5-year adverse outcome-free survivals of anti-gp210+ vs. anti-gp210- patients were 70% and 85%, respectively (P = 0.005). Cirrhosis (P = 0.001), albumin level 40 g/L (P = 0.011) and platelet count 153 x 10(9) (P < 0.001) had a superimposition effect on anti-gp210 antibody as a risk factor. Furthermore, long-term prognoses were evaluated using the UK-PBC and GLOBE scores. For UK-PBC scoring system, the area under receiver operating characteristic curve (AUROC) was 0.924 for all patients with PBC (n = 223), 0.940 for anti-gp210+ patients (n = 110) and 0.888 for anti-gp210- patients (n = 113). For GLOBE scoring system, the area under receiver operating characteristic curve was 0.901 for all patients with PBC (n = 223), 0.924 for anti-gp210+ patients (n = 110) and 0.848 for anti-gp210- patients (n = 113). UK-PBC score >0.0578 (P < 0.001, HR: 32.736, 95% CI: 11.368-94.267) and GLOBE score <0.850 (P < 0.001, HR: 18.763, 95% CI: 7.968-44.180) were associated with poorer outcomes in the whole cohort. Conclusions The UK-PBC and GLOBE scoring systems were good 5-year prognostic predictors in Chinese patients with PBC, especially in anti-gp210+ patients. As a biomarker, anti-gp210 antibody was associated with a more severe cholestatic manifestation and a worse long-term prognosis. The anti-gp210 antibody could be added to further optimise the UK-PBC and GLOBE scoring systems.
引用
收藏
页码:733 / 743
页数:11
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