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The risk predictive values of UK ‐ PBC and GLOBE scoring system in Chinese patients with primary biliary cholangitis: the additional effect of anti‐gp210
Author(s) -
Yang F.,
Yang Y.,
Wang Q.,
Wang Z.,
Miao Q.,
Xiao X.,
Wei Y.,
Bian Z.,
Sheng L.,
Chen X.,
Qiu D.,
Fang J.,
Tang R.,
Gershwin M. E.,
Ma X.
Publication year - 2017
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13927
Subject(s) - medicine , receiver operating characteristic , primary biliary cirrhosis , gastroenterology , area under the curve
Summary Background Adequate risk stratification is critical for the management of the patients with primary biliary cholangitis ( PBC ). The UK ‐ PBC and GLOBE scoring systems for prognosis of PBC have been proposed recently, but have not been validated in Asian population. Aim To validate the UK ‐ PBC and GLOBE scoring systems in Chinese patients for prognosis of PBC . To clarify the role of anti‐gp210 as a biomarker, and to investigate whether anti‐gp210 could affect the prognostic values of UK ‐ PBC and GLOBE scoring systems. Methods We retrospectively analysed 276 patients with PBC evaluated between September 2004 and May 2016, including 133 anti‐gp210+ and 143 anti‐gp210− patients. Results The 5‐year adverse outcome‐free survivals of anti‐gp210+ vs. anti‐gp210− patients were 70% and 85%, respectively ( P = 0.005). Cirrhosis ( P = 0.001), albumin level ≤40 g/L ( P = 0.011) and platelet count ≤153 × 10 9 ( P < 0.001) had a superimposition effect on anti‐gp210 antibody as a risk factor. Furthermore, long‐term prognoses were evaluated using the UK ‐ PBC and GLOBE scores. For UK ‐ PBC scoring system, the area under receiver operating characteristic curve ( AUROC ) was 0.924 for all patients with PBC ( n = 223), 0.940 for anti‐gp210+ patients ( n = 110) and 0.888 for anti‐gp210− patients ( n = 113). For GLOBE scoring system, the area under receiver operating characteristic curve was 0.901 for all patients with PBC ( n = 223), 0.924 for anti‐gp210+ patients ( n = 110) and 0.848 for anti‐gp210− patients ( n = 113). UK ‐ PBC score >0.0578 ( P < 0.001, HR : 32.736, 95% CI : 11.368–94.267) and GLOBE score <0.850 ( P < 0.001, HR : 18.763, 95% CI : 7.968–44.180) were associated with poorer outcomes in the whole cohort. Conclusions The UK ‐ PBC and GLOBE scoring systems were good 5‐year prognostic predictors in Chinese patients with PBC , especially in anti‐gp210+ patients. As a biomarker, anti‐gp210 antibody was associated with a more severe cholestatic manifestation and a worse long‐term prognosis. The anti‐gp210 antibody could be added to further optimise the UK ‐ PBC and GLOBE scoring systems.