Prognostic Value of Biochemical Response Models for Primary Biliary Cholangitis and the Additional Role of the Neutrophil-to-Lymphocyte Ratio.
- Author:
Jeong Ju YOO
1
;
Eun Ju CHO
;
Bora LEE
;
Sang Gyune KIM
;
Young Seok KIM
;
Yun Bin LEE
;
Jeong Hoon LEE
;
Su Jong YU
;
Yoon Jun KIM
;
Jung Hwan YOON
Author Information
- Publication Type:Original Article
- Keywords: Liver cirrhosis, biliary; Prognosis; Neutrophil-to-lymphocyte ratio
- MeSH: Asian Continental Ancestry Group; Cholangitis*; Follow-Up Studies; Humans; Korea; Liver; Liver Cirrhosis, Biliary; Multivariate Analysis; Prognosis; ROC Curve
- From:Gut and Liver 2018;12(6):714-721
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Recently reported prognostic models for primary biliary cholangitis (PBC) have been shown to be effective in Western populations but have not been well-validated in Asian patients. This study aimed to compare the performance of prognostic models in Korean patients and to investigate whether inflammation-based scores can further help in prognosis prediction. METHODS: This study included 271 consecutive patients diagnosed with PBC in Korea. The following prognostic models were evaluated: the Barcelona model, the Paris-I/II model, the Rotterdam criteria, the GLOBE score and the UK-PBC score. The neutrophil-to-lymphocyte ratio (NLR) was analyzed with reference to its association with prognosis. RESULTS: For predicting liver transplant or death at the 5-year and 10-year follow-up examinations, the UK-PBC score (areas under the receiver operating characteristic curve [AUCs], 0.88 and 0.82) and GLOBE score (AUCs, 0.85 and 0.83) were significantly more accurate in predicting prognosis than the other scoring systems (all p < 0.05). There was no significant difference between the performance of the UK-PBC and GLOBE scores. In addition to the prognostic models, a high NLR (>2.46) at baseline was an independent predictor of reduced transplant-free survival in the multivariate analysis (adjusted hazard ratio, 3.74; p < 0.01). When the NLR was applied to the prognostic models, it significantly differentiated the prognosis of patients. CONCLUSIONS: The UK-PBC and GLOBE scores showed good prognostic performance in Korean patients with PBC. In addition, a high NLR was associated with a poorer prognosis. Including the NLR in prognostic models may further help to stratify patients with PBC.
