血清自体表皮生长因子水平可预测原发性胆汁性胆管炎患者的肝脏相关事件:一项长期多中心观察研究:自体表皮生长因子可预测原发性胆汁性胆管炎患者的肝脏相关事件

IF 3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Clinical and Translational Gastroenterology Pub Date : 2024-10-17 DOI:10.14309/ctg.0000000000000779
Takanobu Iwadare, Takefumi Kimura, Yuki Yamashita, Taiki Okumura, Shun-Ichi Wakabayashi, Hiroyuki Kobayashi, Ayumi Sugiura, Tomoo Yamazaki, Satoshi Shimamoto, Koji Igarashi, Satoru Joshita, Takeji Umemura
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引用次数: 0

摘要

背景:迄今为止,还没有一种直接、可靠和无创的方法来预测原发性胆汁性胆管炎(PBC)肝脏相关事件(LRE)的发生。本研究探讨了血清自体表皮生长因子(ATX)能否预测原发性胆汁性胆管炎患者的肝脏相关事件(LRE):这项回顾性多中心调查包括190名经活检证实未经治疗的PBC患者。所有受试者都接受了至少一年的随访,在此期间,研究人员根据肝活检时的 ATX 水平调查了 LRE 的发生率,包括新发肝细胞癌、食管胃静脉曲张、腹水和肝性脑病:在中位 9.7 年的随访期间,22 名患者(11.6%)观察到 LRE。预测 LRE 的接收者操作特征曲线下面积和血清 ATX 临界值分别为 0.80 和 1.086 mg/L。与 ATX < 1.086 的患者相比,血清 ATX ≥ 1.086 的患者 LRE 累积发生率明显更高(33.3% 对 3.6%,P < 0.00001)。值得注意的是,ATX对PBC患者LRE的预测能力超过了FIB-4、ALBI、APRI和M2BPGi。多变量 Cox 比例危险模型显示,ATX 与中沼分期(危险比 2.75,95% 置信区间 1.52-4.99,p <0.001)是 LRE 的独立相关因素(危险比 6.24,95% 置信区间 1.87-20.80,p = 0.003)。这些结果在经血清学诊断的 PBC 验证队列(n = 32)中得到了紧密的重复:血清 ATX 水平可作为 PBC 患者 LRE 的预测指标。
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Serum Autotaxin Levels Predict Liver-Related Events in Primary Biliary Cholangitis Patients: A Long-term Multicenter Observational Study: Autotaxin predict liver-related events in PBC.

Background: A straightforward, reliable, and noninvasive method for predicting the development of liver-related events (LRE) in primary biliary cholangitis (PBC) has not been attained thus far. The present study investigated whether serum autotaxin (ATX) could predict liver-related events (LRE) in PBC patients.

Methods: This retrospective multicenter investigation included 190 biopsy-proven untreated PBC patients. All subjects were followed for at least 1 year, during which time the prevalence of LRE, including newly developing hepatocellular carcinoma, esophagogastric varices, ascites, and hepatic encephalopathy, was investigated in relation to ATX levels at the time of liver biopsy.

Results: During the median follow-up period of 9.7 years, LRE were observed in 22 patients (11.6%). The area under the receiver operating characteristic curve and cut-off value of serum ATX for predicting LRE were 0.80 and 1.086 mg/L, respectively. Patients with serum ATX ≥ 1.086 had a significantly higher cumulative incidence of LRE compared with patients with ATX < 1.086 (33.3% vs. 3.6%, p < 0.00001). Notably, the predictive capability of ATX for LRE in PBC patients surpassed that of FIB-4, ALBI, APRI, and M2BPGi. A multivariate Cox proportional hazards model revealed ATX as an independent associated factor for LRE (hazard ratio 6.24, 95% confidence interval 1.87-20.80, p = 0.003) along with Nakanuma stage (hazard ratio 2.75, 95% confidence interval 1.52-4.99, p < 0.001). These results were closely replicated in a serologically diagnosed PBC validation cohort (n = 32).

Conclusion: Serum ATX levels may serve as a predictive marker for LRE in patients with PBC.

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来源期刊
Clinical and Translational Gastroenterology
Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
7.00
自引率
0.00%
发文量
114
审稿时长
16 weeks
期刊介绍: Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.
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