Prognostic Significance of Bile Duct Loss in Early-Stage Primary Biliary Cholangitis: A Long-Term Observational Study.

IF 3.4 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Hepatology Research Pub Date : 2025-08-19 DOI:10.1111/hepr.70018

Taiki Okumura, Takefumi Kimura, Takanobu Iwadare, Shun-Ichi Wakabayashi, Hiroyuki Kobayashi, Yuki Yamashita, Satoru Joshita, Michiharu Komatsu, Naoki Tanaka, Akihiro Matsumoto, Tomoyuki Nakajima, Mai Iwaya, Masahiro Umemura, Kazuhito Kawata, Kenichi Harada, Takeji Umemura

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引用次数: 0

Abstract

Background & aims: Primary biliary cholangitis (PBC) is a chronic, slowly progressive, and autoimmune liver disease. This study aimed to establish the clinicopathological features that accurately predict long-term prognosis in patients with early-stage PBC.

Methods: The present long-term (8.8 years), multicenter, and retrospective investigation enrolled 274 treatment-naïve PBC patients who had undergone liver biopsy. Among them, 207 patients with albumin-bilirubin (ALBI) grade 1 were categorized as clinical early-stage, and 230 patients with Nakanuma stage 1/2 were classified as pathological early-stage. The prognostic factors related to the time to liver-related events (LRE) were statistically evaluated.

Results: Cox regression analysis identified Nakanuma bile duct loss score of ≥ 1 as a significant independent factor associated with LRE development in clinical early-stage PBC patients (hazard ratio [HR] 12.89, 95% confidence interval [95% CI] 1.60-103.96, P = 0.016). Kaplan-Meier testing revealed that the cumulative incidence of LRE was significantly higher in patients with bile duct loss score of ≥ 1 than in those with bile duct loss score 0 (log-rank test; P < 0.001). Similarly, bile duct loss score could predict LRE in pathological early-stage PBC patients, as confirmed by both multivariable Cox regression (HR 6.60, 95% CI 1.37-31.86, P = 0.019) and Kaplan-Meier (log-rank test; P < 0.001) analyses.

Conclusions: Nakanuma bile duct loss score may be a valuable prognostic indicator in the early clinical and pathological stages of PBC.

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早期原发性胆道胆管炎中胆管损失的预后意义：一项长期观察研究。

背景与目的：原发性胆道胆管炎（PBC）是一种慢性、缓慢进展的自身免疫性肝病。本研究旨在建立能够准确预测早期PBC患者长期预后的临床病理特征。方法：目前的长期（8.8年）、多中心和回顾性研究纳入了274例treatment-naïve PBC患者，他们接受了肝活检。其中，ALBI 1级患者207例为临床早期，Nakanuma 1/2期患者230例为病理早期。统计评价与肝相关事件发生时间（LRE）相关的预后因素。结果：Cox回归分析发现，Nakanuma胆管损失评分≥1是临床早期PBC患者LRE发展的重要独立因素（风险比[HR] 12.89, 95%可信区间[95% CI] 1.60-103.96, P = 0.016）。Kaplan-Meier检验显示，胆管损失评分≥1的患者LRE的累积发生率明显高于胆管损失评分为0的患者（log-rank检验；P）。结论：Nakanuma胆管损失评分可能是PBC早期临床和病理阶段有价值的预后指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hepatology Research 医学-胃肠肝病学

CiteScore

8.30

自引率

14.30%

发文量

124

审稿时长

1 months

期刊介绍： Hepatology Research (formerly International Hepatology Communications) is the official journal of the Japan Society of Hepatology, and publishes original articles, reviews and short comunications dealing with hepatology. Reviews or mini-reviews are especially welcomed from those areas within hepatology undergoing rapid changes. Short communications should contain concise definitive information.