|
PBC |Abstract Library |
 |
|
The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors. |
Abstract Details |
 |
|
|
|
|
|
|
|
Accuracy of Transient Elastography in assessing fibrosis at diagnosis in naïve patients with Primary Biliary Cholangitis: a dual cut-off approach |
|
|
|
|
|
Hepatology. 2021 Mar 16. doi: 10.1002/hep.31810. Online ahead of print.
Laura Cristoferi 1 2 3, Vincenza Calvaruso 4, Diletta Overi 5, Mauro Viganò 6, Cristina Rigamonti 7, Elisabetta Degasperi 8, Vincenzo Cardinale 9, Sara Labanca 10, Nicola Zucchini 11, Anna Fichera 4, Vito Di Marco 4, Monica Leutner 12, Rosanna Venere 13, Antonino Picciotto 10, Martina Lucà 1 2, Giacomo Mulinacci 1 2, Andrea Palermo 1 2, Alessio Gerussi 1 2, Daphne D'Amato 1 2, Sarah Elisabeth O'Donnell 1 2, Federica Cerini 6, Carla De Benedittis 7, Federica Malinverno 1 2, Vincenzo Ronca 1 2, Clara Mancuso 1 2, Nora Cazzagon 14, Antonio Ciaccio 1 2, Donatella Barisani 1, Marco Marzioni 15, Annarosa Floreani 16 17, Domenico Alvaro 9, Eugenio Gaudio 5, Pietro Invernizzi 1 2, Guido Carpino 18, Alessandra Nardi 19, Marco Carbone 1 2, behalf of the Italian PBC Registry
|
|
|
|
|
Author information
- 1Division of Gastroenterology, Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
- 2European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy.
- 3Bicocca Bioinformatics Biostatistics and Bioimaging Centre - B4, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
- 4Section of Gastroenterology and Hepatology, PROMISE, University of Palermo, Palermo, Italy.
- 5Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy.
- 6Division of Hepatology, Ospedale San Giuseppe, University of Milan, Milan, Italy.
- 7Department of Translational Medicine, Università degli Studi del Piemonte Orientale "A. Avogadro", Novara, Italy.
- 8CRC "A. M. e A. Migliavacca" Center for Liver Diseases, Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
- 9Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino "Sapienza" University of Rome, Latina, Italy.
- 10Department of Internal Medicine, University of Genova, Genova, Italy.
- 11San Gerardo Hospital, Pathology department, Monza, Italy.
- 12Histopathology Unit, AOU Maggiore della Carità, Novara, Italy.
- 13Department of Precision and Translational Medicine, Sapienza University of Rome, Rome, Italy.
- 14Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.
- 15Università Politecnica delle Marche", Department of Gastroenterology, Ancona, Italy.
- 16Studiosa Senior, University of Padova, Italy, Padova.
- 17Scientific Consultant, IRCCS Negrar, Verona, Italy.
- 18Department of Movement, Human and Health Science, University of Rome "Foro Italico", Rome, Italy.
- 19Department of Mathematics, University of Rome Tor Vergata, Rome, Italy.
Abstract
Background & aims: Liver fibrosis holds a relevant prognostic meaning in primary biliary cholangitis (PBC). Non-invasive fibrosis evaluation using vibration-controlled transient elastography (VCTE) is routinely performed. However, there is limited evidence on its accuracy at diagnosis in PBC. We aimed to estimate the diagnostic accuracy of VCTE in assessing advanced fibrosis at disease presentation in PBC.
Approach & results: We collected data from 167 consecutive treatment-naïve PBC patients who underwent liver biopsy(LB) at diagnosis at six Italian centers. VCTE examinations were completed within 12 weeks of LB. Biopsies were scored by two blinded expert pathologists, according to Ludwig system. Diagnostic accuracy was estimated using the area under the receiver operating characteristic curves(AUROCs) for advanced fibrosis (Ludwig stage≥III). The effects of biochemical and clinical parameters on liver stiffness measurement (LSM) were appraised. Derivation cohort consisted of 126 patients with valid LSM and LB, VCTE identified patients with advanced fibrosis with AUROC of 0.89. LSM cut-offs ≤6.5kPa and >11.0kPa enabled to exclude and confirm, respectively, advanced fibrosis (negative predictive value[NPV]=0.94, positive predictive value[PPV]=0.89, error rate=5.6%). These values were externally validated in an independent cohort of 91 PBC patients(NPV=0.93, PPV=0.89, error rate=8.6%). Multivariable analysis found the only parameter affecting LSM was fibrosis stage. No association was found with BMI and liver biochemistry.
Conclusions: In a multicenter study of treatment-naïve PBC patients, we identified two cut-offs (LSM≤6.5kPa and>11.0kPa) able to discriminate at diagnosis the presence or the absence, respectively, of advanced fibrosis in PBC patients, with external validation. In patients with LSM between these two cut-offs, VCTE is not reliable and liver biopsy should be evaluated for accurate disease staging. BMI and liver biochemistry did not affect LSMs.
|
|
|
|
|
|
|
|
|
|
|
|
|