Noninvasive elastography-based assessment of liver fibrosis in primary biliary cholangitis

Transient elastography (TE) has been widely used in clinical practice, but noninvasive prediction models based on TE for the assessment of liver fibrosis in primary biliary cholangitis (PBC) has not been reported before. The aim of this study is to develop the simple, accurate and noninvasive prediction models for the histologic staging of PBC based on TE.

Serologic testing, liver stiffness measurement (LSM), and histological assessment of 144 patients with PBC were collected retrospectively. In model group consisted of 96 patients, LSM and alkaline phosphatase (ALP) were identified as two independent predictors of PBC histological stage, which were used to establish two noninvasive models, Model A and Model B, to predict significant fibrosis (Ludwig stage ≥ 2) and advanced fibrosis (Ludwig stage ≥ 3), respectively. The performance of noninvasive models was then validated in the validation group (48 patients).

The area under the ROC curve (AUROC) of Model A was 0.870 (95 % CI, 0.802-0.939) in the model group and 0.914 (95 % CI, 0.803-1.000) in the validation group. The AUROC of Model B was 0.948 (95 % CI, 0.888-0.998) in the model group and 0.906 (95 % CI, 0.824-0.987) in validation group. The above results were higher than the other five serologic markers.

The Model A and Model B were the efficient noninvasive models with high accuracy in predicting the histological stages of PBC.