Liver fibrosis progression predicts survival in patients with primary biliary cirrhosis

被引：18

作者：

Namisaki, Tadashi ^{[1
]}

Moriya, Kei ^{[1
]}

Noguchi, Ryuichi ^{[1
]}

Kitade, Mitsuteru ^{[1
]}

Kawaratani, Hideto ^{[1
]}

Yamao, Junichi ^{[2
]}

Mitoro, Akira ^{[1
]}

Yoshida, Motoyuki ^{[1
]}

Sawai, Masayoshi ^{[2
]}

Uejima, Masakazu ^{[1
]}

Mashitani, Tsuyoshi ^{[1
]}

Takeda, Kosuke ^{[1
]}

Okura, Yasushi ^{[2
]}

Kaji, Kosuke ^{[1
]}

Takaya, Hiroaki ^{[1
]}

Aihara, Yosuke

Douhara, Akitoshi ^{[1
]}

Nishimura, Norihisa ^{[1
]}

Sawada, Yasuhiko ^{[1
]}

Sato, Shinya ^{[1
]}

Seki, Kenichiro ^{[1
]}

Yoshiji, Hitoshi ^{[1
]}

机构：

[1] Nara Med Univ, Dept Internal Med 3, 840 Shijo Cho, Kashihara, Nara 6348522, Japan

[2] Nara Med Univ Hosp, Dept Endoscopy & Ultrasound, Kashihara, Nara, Japan

来源：

HEPATOLOGY RESEARCH | 2017年 / 47卷 / 03期

关键词：

bile duct loss; biochemical response to ursodeoxycholic acid; liver fibrosis; primary biliary cirrhosis; BIOCHEMICAL RESPONSE; URSODEOXYCHOLIC ACID; GRADING SYSTEM; HISTOLOGICAL PROGRESSION; PATHOLOGIST; VALIDATION; PROGNOSIS;

D O I：

10.1111/hepr.12746

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

AimThe prognosis and natural history of primary biliary cirrhosis (PBC) has improved, and the clinical end-point for PBC needs to be discovered. We aimed to identify surrogate markers for predicting long-term prognosis in patients with PBC. MethodsA total of 106 patients were divided into 53 responders and 53 non-responders based on the median rate (69%) of decrease in -glutamyl transpeptidase levels at 1 year after initiating ursodeoxycholic acid therapy. We aimed to identify the differences between ursodeoxycholic acid responders and non-responders. Correlation of patient survival with histologic parameters based on Scheuer and Nakanuma staging systems was investigated. The Nakanuma system comprises grading for liver fibrosis and bile duct loss (BDL). ResultsThe baseline pathological stage was the only factor that showed differences between the two groups. Patients in Scheuer stage 1 had a significantly better prognosis than patients in Scheuer stages 3 or 4 (P < 0.05 and P < 0.01, respectively), whereas patients in Nakanuma stage 1 had significantly better prognosis than patients in Nakanuma stage 4 (P < 0.01). Patients with Nakanuma fibrosis scores 2 and 3 had decreased survival compared with patients with fibrosis score 0 (P < 0.05 and P < 0.01, respectively), whereas patients with Nakanuma BDL score 3 had decreased survival compared with patients with BDL score 0 (P < 0.01). ConclusionLong-term prognosis could be predicted by Scheuer stage 3 and Nakanuma fibrosis score 2, which were referred to as portal-bridging fibrosis. Liver fibrosis has greater utility in predicting long-term prognosis than BDL.

引用

页码：E178 / E186

页数：9

共 29 条

[1] Utilization of the Mayo risk score in patients with primary biliary cirrhosis receiving ursodeoxycholic acid [J].

Angulo, P ;

Lindor, KD ;

Therneau, TM ;

Jorgensen, RA ;

Malinchoc, M ;

Kamath, PS ;

Dickson, ER .

LIVER, 1999, 19 (02) :115-121

[2] Biochemical response to ursodeoxycholic acid predicts long-term outcome in Japanese patients with primary biliary cirrhosis [J].

Azemoto, Nobuaki ;

Kumagi, Teru ;

Abe, Masanori ;

Konishi, Ichiro ;

Matsuura, Bunzo ;

Hiasa, Yoichi ;

Onji, Morikazu .

HEPATOLOGY RESEARCH, 2011, 41 (04) :310-317

[3] Early biochemical response to ursodeoxycholic acid predicts symptom development in patients with asymptomatic primary biliary cirrhosis [J].

Azemoto, Nobuaki ;

Abe, Masanori ;

Murata, Yosuke ;

Hiasa, Yoichi ;

Hamada, Maho ;

Matsuura, Bunzo ;

Onji, Morikazu .

JOURNAL OF GASTROENTEROLOGY, 2009, 44 (06) :630-634

[4] The UK-PBC Risk Scores: Derivation and Validation of a Scoring System for Long-Term Prediction of End-Stage Liver Disease in Primary Biliary Cholangitis [J].

Carbone, Marco ;

Sharp, Stephen J. ;

Flack, Steve ;

Paximadas, Dimitrios ;

Spiess, Kelly ;

Adgey, Carolyn ;

Griffiths, Laura ;

Lim, Reyna ;

Trembling, Paul ;

Williamson, Kate ;

Wareham, Nick J. ;

Aldersley, Mark ;

Bathgate, Andrew ;

Burroughs, Andrew K. ;

Heneghan, Michael A. ;

Neuberger, James M. ;

Thorburn, Douglas ;

Hirschfield, Gideon M. ;

Cordell, Heather J. ;

Alexander, Graeme J. ;

Jones, David E. J. ;

Sandford, Richard N. ;

Mells, George F. .

HEPATOLOGY, 2016, 63 (03) :930-950

[5] Sex and Age Are Determinants of the Clinical Phenotype of Primary Biliary Cirrhosis and Response to Ursodeoxycholic Acid [J].

Carbone, Marco ;

Mells, George F. ;

Pells, Greta ;

Dawwas, Muhammad F. ;

Newton, Julia L. ;

Heneghan, Michael A. ;

Neuberger, James M. ;

Day, Darren B. ;

Ducker, Samantha J. ;

Sandford, Richard N. ;

Alexander, Graeme J. ;

Jones, David E. J. .

GASTROENTEROLOGY, 2013, 144 (03) :560-+

[6] Primary biliary cirrhosis [J].

Carey, Elizabeth J. ;

Ali, Ahmad H. ;

Lindor, Keith D. .

LANCET, 2015, 386 (10003) :1565-1575

[7] Primary biliary cirrhosis autoimmune hepatitis overlap syndrome:: Clinical features and response to therapy [J].

Chazouillères, O ;

Wendum, D ;

Serfaty, L ;

Montembault, S ;

Rosmorduc, O ;

Poupon, R .

HEPATOLOGY, 1998, 28 (02) :296-301

[8] A systematic review of the quality of liver biopsy specimens [J].

Cholongitas, E ;

Senzolo, M ;

Standish, R ;

Marelli, L ;

Quaglia, A ;

Patch, D ;

Dhillon, AP ;

Burroughs, AK .

AMERICAN JOURNAL OF CLINICAL PATHOLOGY, 2006, 125 (05) :710-721

[9] Biochemical response to ursodeoxycholic acid and long-term prognosis in primary biliary cirrhosis [J].

Corpechot, Christophe ;

Abenavoli, Ludovico ;

Rabahi, Nabila ;

Chretien, Yves ;

Andreani, Tony ;

Johanet, Catherine ;

Chazouilleres, Olivier ;

Poupon, Raoul .

HEPATOLOGY, 2008, 48 (03) :871-877

[10] Early primary biliary cirrhosis: Biochemical response to treatment and prediction of long-term outcome [J].

Corpechot, Christophe ;

Chazouilleres, Olivier ;

Poupon, Raoul .

JOURNAL OF HEPATOLOGY, 2011, 55 (06) :1361-1367

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