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. 2024 Feb;18(1):206-215.
doi: 10.1007/s12072-023-10587-w. Epub 2023 Sep 19.

Prognostic significance of liver stiffness in patients with primary biliary cholangitis: validation of Baveno VII criteria

Dawei Ding #  1 , Guanya Guo #  1 , Lina Cui  1 , Gui Jia  1 , Xiufang Wang  1 , Miao Zhang  1 , Siyuan Tian  1 , Linhua Zheng  1 , Yansheng Liu  1 , Yinan Hu  1 , Guoyun Xuan  1 , Jiaqi Yang  1 , Chunmei Yang  1 , Ruiqing Sun  1 , Juan Deng  1 , Changcun Guo  1 , Yu Chen  2 , Yulong Shang  3 , Ying Han  4
Affiliations

Prognostic significance of liver stiffness in patients with primary biliary cholangitis: validation of Baveno VII criteria

Dawei Ding et al. Hepatol Int. 2024 Feb.

Abstract

Background: The role of liver stiffness measurements (LSM) in patients with primary biliary cholangitis (PBC) remains to be further elucidated.

Aims: To clarify the prognostic role of LSM and to validate the "novel concepts" proposed by the Baveno VII Working Group.

Methods: An analysis of the prognostic significance of LSM was performed involving 672 patients.

Results: LSM and ΔLSM/ΔT were independent risk factors for liver decompensation, liver transplantation, or liver-related death (primary outcomes, p < 0.001, both). A rule of 5 kPa for LSM (10-15-20 kPa) could be used to denote progressively higher relative risks of primary outcomes. Patients with LSM < 10 kPa have a negligible 3-year risk of primary outcomes (< 1%). Cut-off values of 10 and 15 kPa can be used to classify PBC patients into low-, medium-, and high-risk groups. A clinically significant decrease in LSM, evaluated at 6, 12, or 24 months elastography tests, was associated with a substantially reduced risk of primary outcomes (p < 0.05, all), which can be defined as a decrease in LSM of > - 20% associated with LSM < 20 kPa or any decrease to LSM < 10 kPa. A clinically significant increase in LSM, evaluated at 6, 12, or 24 months elastography tests, was associated with a substantially raised risk of primary outcomes (p < 0.05, all), which can be defined as an increase in LSM of ≥ + 20% or any increase to LSM ≥ 15 kPa.

Conclusions: LSM can be used to monitor disease progression and predict long-term prognosis in patients with PBC.

Keywords: Liver stiffness measurements; Primary biliary cholangitis; Prognosis; Retrospective cohort study.

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Conflict of interest statement

Dawei Ding, Guanya Guo, Lina Cui, Gui Jia, Xiufang Wang, Miao Zhang, Siyuan Tian, Linhua Zheng, Yansheng Liu, Yinan Hu, Guoyun Xuan, Jiaqi Yang, Chunmei Yang, Ruiqing Sun, Juan Deng, Changcun Guo, Yu Chen, Yulong Shang and Ying Han have no conflict of interests related to this publication.

Figures

Fig. 1
Fig. 1
Case screening process and study design. Of these 120 decompensated patients excluded from the study, 75 (63%) had ascites, 43 (36%) had variceal bleeding, and 2 (2%) had hepatic encephalopathy
Fig. 2
Fig. 2
Kaplan–Meier plots of the primary outcome-free survival of patients with PBC based on the rule of 5 kPa (10–15–20 kPa)
Fig. 3
Fig. 3
Kaplan–Meier plots of the primary outcome-free survival of patients with a clinically significant decrease in LSM (CSDL) and without CSDL. a Evaluated at 6-month elastography test; b Evaluated at 12 months; c Evaluated at 24 months
Fig. 4
Fig. 4
Kaplan–Meier plots of the primary outcome-free survival of median-risk (10 ≤ LSM < 15 kPa) patients with a clinically significant increase in LSM (CSIL) and without CSIL. a Evaluated at 6-month elastography test; b Evaluated at 12 months; c Evaluated at 24 months
See this image and copyright information in PMC

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