Serum FGF19 combined with GGT and other biomarkers predicted native liver survival following Kasai portoenterostomy in early biliary atresia.

IF 6.9 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology Pub Date : 2025-06-01 Epub Date: 2025-05-05 DOI:10.1007/s00535-025-02234-y

Jiajie Zhu, Huifen Chen, Lingdu Meng, Jingying Jiang, Yifan Yang, Junfeng Wang, Xue Ren, Fanyang Kong, Rui Dong, Gong Chen, Shan Zheng

{"title":"Serum FGF19 combined with GGT and other biomarkers predicted native liver survival following Kasai portoenterostomy in early biliary atresia.","authors":"Jiajie Zhu, Huifen Chen, Lingdu Meng, Jingying Jiang, Yifan Yang, Junfeng Wang, Xue Ren, Fanyang Kong, Rui Dong, Gong Chen, Shan Zheng","doi":"10.1007/s00535-025-02234-y","DOIUrl":null,"url":null,"abstract":"Background: Accurately predicting the prognosis of biliary atresia (BA) prior to Kasai portoenterostomy (KPE) remains a challenge. The identification of the specific BA population that may benefit from primary liver transplantation (pLT) instead of KPE remains elusive.Methods: A total of 196 BA patients and 31 age-matched non-BA cholestasis patients were recruited. BA patients were divided into training (February 2018-February 2019) and validation (March 2019-December 2021) cohorts. C-index was applied to evaluate the utility of indicators and models.Results: Serum fibroblast growth factor 19 (FGF19) was elevated in BA patients [95.67 (58.97-140.6) vs. 58.73 (43.59-85.35) pg/ml, P = 0.0003]. Constructed with FGF19, GGT, DBIL, and ALB, nomogram A demonstrated optimal C-index in training (0.767 ± 0.039) and validation (0.721 ± 0.062) cohorts with ideal consistency in predicting 1-year NLS after KPE as well as potential clinically utility in BA patients with an age at KPE ≤ 60 days. Leveraging the risk score (RS) developed with nomogram A, our findings revealed a notable decrease in 2-year NLS after KPE among BA patients with a preoperative RS > 1.36, and the patients with a preoperative RS > 2.6 appear to be potential candidates for pLT [2-year NLS after KPE: 0% (training cohort), 21.4% (validation cohort); specificity = 100% and sensitivity = 22.2%].Conclusions: Nomogram A demonstrated significant efficacy in preoperatively predicting NLS in early BA. BA patients (age at KPE ≤ 60 days) with a RS > 2.6 may potentially benefit from pLT.","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"783-793"},"PeriodicalIF":6.9000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00535-025-02234-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/5 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Accurately predicting the prognosis of biliary atresia (BA) prior to Kasai portoenterostomy (KPE) remains a challenge. The identification of the specific BA population that may benefit from primary liver transplantation (pLT) instead of KPE remains elusive.

Methods: A total of 196 BA patients and 31 age-matched non-BA cholestasis patients were recruited. BA patients were divided into training (February 2018-February 2019) and validation (March 2019-December 2021) cohorts. C-index was applied to evaluate the utility of indicators and models.

Results: Serum fibroblast growth factor 19 (FGF19) was elevated in BA patients [95.67 (58.97-140.6) vs. 58.73 (43.59-85.35) pg/ml, P = 0.0003]. Constructed with FGF19, GGT, DBIL, and ALB, nomogram A demonstrated optimal C-index in training (0.767 ± 0.039) and validation (0.721 ± 0.062) cohorts with ideal consistency in predicting 1-year NLS after KPE as well as potential clinically utility in BA patients with an age at KPE ≤ 60 days. Leveraging the risk score (RS) developed with nomogram A, our findings revealed a notable decrease in 2-year NLS after KPE among BA patients with a preoperative RS > 1.36, and the patients with a preoperative RS > 2.6 appear to be potential candidates for pLT [2-year NLS after KPE: 0% (training cohort), 21.4% (validation cohort); specificity = 100% and sensitivity = 22.2%].

Conclusions: Nomogram A demonstrated significant efficacy in preoperatively predicting NLS in early BA. BA patients (age at KPE ≤ 60 days) with a RS > 2.6 may potentially benefit from pLT.

查看原文本刊更多论文

血清FGF19联合GGT和其他生物标志物预测早期胆道闭锁Kasai门肠造口术后的天然肝脏存活。

背景：在Kasai门肠造口术（KPE）之前准确预测胆道闭锁（BA）的预后仍然是一个挑战。特异性BA人群可能受益于原发性肝移植（pLT）而不是KPE的鉴定仍然难以捉摸。方法：共招募了196例BA患者和31例年龄匹配的非BA型胆汁淤积患者。BA患者被分为训练组（2018年2月- 2019年2月）和验证组（2019年3月- 2021年12月）。采用c指数对指标和模型的效用进行评价。结果：BA患者血清成纤维细胞生长因子19 （FGF19）升高[95.67（58.97 ~ 140.6）比58.73 (43.59 ~ 85.35)pg/ml, P = 0.0003]。由FGF19、GGT、DBIL和ALB组成的nomogram A在训练队列（0.767±0.039）和验证队列（0.721±0.062）中显示出最佳的c指数，在预测KPE后1年NLS以及KPE年龄≤60天的BA患者的潜在临床应用方面具有理想的一致性。利用nomogram A开发的风险评分（RS），我们的研究结果显示术前RS >为1.36的BA患者KPE后2年NLS显著降低，术前RS >为2.6的患者似乎是pLT的潜在候选者[KPE后2年NLS: 0%（训练队列），21.4%（验证队列）；特异性= 100%，敏感性= 22.2%]。结论：Nomogram A在术前预测早期BA患者NLS方面具有显著的疗效。RS为2.6的BA患者（KPE年龄≤60天）可能从pLT中获益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Gastroenterology 医学-胃肠肝病学

CiteScore

12.20

自引率

1.60%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.