S-6 Non-invasive assessment of liver fibrosis and prognostic outcomes in Asian patients with PBC = S-6 Non-invasive assessment of liver fibrosis and prognostic outcomes in Asian patients with PBC

다국어 초록 (Multilingual Abstract)

In primary biliary cirrhosis (PBC), biliary injuries may eventually lead to cirrhosis and liver failure with various incidence rates. In this study, we aimed to evaluate the performance of non-invasive assessments of liver fibrosis and determine prognostic factors leading to liver-related events (LREs) in Asian patients with biopsy-proven primary biliary cirrhosis receiving ursodeoxycholic acid (UDCA) therapy. Since 2005 to 2015, 174 patients were diagnosed PBC with liver biopsy and regularly followed up for a median period of 47.3 months. 9.3% (17 cases) of them presented LREs. Their baseline liver stiffness value measured (LSM) by transient elastography and serum markers of AST/ALT ratio, AST to Platelet ratio index, FIB-4 score and Forns score were evaluated to prove abilities of assessing advanced fibrosis, correlated to liver biopsy. Those baseline factors and biochemical treatment responses to UDCA evaluated at 1 year after treatment (Paris II criterion, Barcelona criterion, Rotterdam criterion) were analyzed to determine prognostic factors. Compared to the minor fibrosis group, advanced fibrosis group had higher LSM, AST/ALT ratio, APRI, and FIB-4 score. Correlated to the results of liver biopsy, LSM, as a single assessment value, showed most precise results with AUROC of 0.882. Within baseline assessments, age, advanced fibrosis, LSM, APRI, and FIB-4 score were significantly related to occurrence of LREs, and among them, FIB-4 score was proved as the single most powerful factor with hazard ratio (HR) of 19.781. After 1 year treatment with UDCA, in the group of non-responders by Rotterdam criterion, the incidence rate of LREs was the highest. Baseline assessments of non-invasive serum markers and LSM represent prognostic surrogate markers of liver fibrosis and prognosis in Asian patients with PBC. And the Rotterdam criterion seems to be most useful criterion to determine of biochemical treatment response to UDCA for Asian patients.