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Prognostic Value of Biochemical Response Models for Primary Biliary Cholangitis and the Additional Role of the Neutrophil-to-Lymphocyte Ratio

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...

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Autores principales: Yoo, Jeong-Ju, Cho, Eun Ju, Lee, Bora, Kim, Sang Gyune, Kim, Young Seok, Lee, Yun Bin, Lee, Jeong-Hoon, Yu, Su Jong, Kim, Yoon Jun, Yoon, Jung-Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Editorial Office of Gut and Liver 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254625/
https://www.ncbi.nlm.nih.gov/pubmed/30400732
http://dx.doi.org/10.5009/gnl18271
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author Yoo, Jeong-Ju
Cho, Eun Ju
Lee, Bora
Kim, Sang Gyune
Kim, Young Seok
Lee, Yun Bin
Lee, Jeong-Hoon
Yu, Su Jong
Kim, Yoon Jun
Yoon, Jung-Hwan
author_facet Yoo, Jeong-Ju
Cho, Eun Ju
Lee, Bora
Kim, Sang Gyune
Kim, Young Seok
Lee, Yun Bin
Lee, Jeong-Hoon
Yu, Su Jong
Kim, Yoon Jun
Yoon, Jung-Hwan
author_sort Yoo, Jeong-Ju
collection PubMed
description 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.
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spelling pubmed-62546252018-11-26 Prognostic Value of Biochemical Response Models for Primary Biliary Cholangitis and the Additional Role of the Neutrophil-to-Lymphocyte Ratio Yoo, Jeong-Ju Cho, Eun Ju Lee, Bora Kim, Sang Gyune Kim, Young Seok Lee, Yun Bin Lee, Jeong-Hoon Yu, Su Jong Kim, Yoon Jun Yoon, Jung-Hwan Gut Liver Original Article 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. Editorial Office of Gut and Liver 2018-11 2018-10-29 /pmc/articles/PMC6254625/ /pubmed/30400732 http://dx.doi.org/10.5009/gnl18271 Text en Copyright © 2018 by The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Yoo, Jeong-Ju
Cho, Eun Ju
Lee, Bora
Kim, Sang Gyune
Kim, Young Seok
Lee, Yun Bin
Lee, Jeong-Hoon
Yu, Su Jong
Kim, Yoon Jun
Yoon, Jung-Hwan
Prognostic Value of Biochemical Response Models for Primary Biliary Cholangitis and the Additional Role of the Neutrophil-to-Lymphocyte Ratio
title Prognostic Value of Biochemical Response Models for Primary Biliary Cholangitis and the Additional Role of the Neutrophil-to-Lymphocyte Ratio
title_full Prognostic Value of Biochemical Response Models for Primary Biliary Cholangitis and the Additional Role of the Neutrophil-to-Lymphocyte Ratio
title_fullStr Prognostic Value of Biochemical Response Models for Primary Biliary Cholangitis and the Additional Role of the Neutrophil-to-Lymphocyte Ratio
title_full_unstemmed Prognostic Value of Biochemical Response Models for Primary Biliary Cholangitis and the Additional Role of the Neutrophil-to-Lymphocyte Ratio
title_short Prognostic Value of Biochemical Response Models for Primary Biliary Cholangitis and the Additional Role of the Neutrophil-to-Lymphocyte Ratio
title_sort prognostic value of biochemical response models for primary biliary cholangitis and the additional role of the neutrophil-to-lymphocyte ratio
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254625/
https://www.ncbi.nlm.nih.gov/pubmed/30400732
http://dx.doi.org/10.5009/gnl18271
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