An analysis for the diagnostic?significance of clinical manifestation, autoantibodies and liver pathology of 84 patients with primary biliary cholangitis

Abstract

Abstract: Objective To analyze the clinical features, autoantibodies and the diagnostic significance of liver histopathology of primary biliary cholangitis (PBC), in order to improve the understanding of this disease. Methods The clinical characteristics, results of autoantibody tests and liver histopathological examination of 84 patients diagnosed with PBC or PBC-AIH overlap syndrome were analyzed. Results Among the 84 patients, the male to female ratio was 1:4.6, and the average age was (55.54±11.10) years. Among the common clinical symptoms, the incidence of skin pruritus in AMA-M2-positive patients (27.3%) is higher than that in AMA-M2-negative patients (3.4%), with statistical difference (χ²=6.990, P=0.008). The results of autoantibody tests indicated that the positive rates of AMA-M2, p210 and Sp100 were 65.5%, 23.8%, and 16.7%, respectively. Among 52 patients who underwent liver biopsies, 23 each of AMA-M2 positive and AMA-M2 negative patients have histopathologically confirmed PBC. Compared with the AMA-M2 positive patients, the AMA-M2 negative patients had more cases with significant fibrosis (i.e., PBC stage III, 7.3% vs 24.1%, χ²=4.746, P=0.042). Conclusion AMA positive has high sensitivity and specificity for the diagnosis of PBC. However, AMA-M2 negative PBC is also common in Chinese patients. Although the combination of Sp100 and gp210 tests can improve the diagnostic rate of PBC patients, the diagnosis was still easy to be missed or delayed. Histopathological examination to achieve early diagnosis and treatment is also important for improving the patient's prognosis and life qualities.

Key words: Primary Biliary Cholangitis, Autoantibodies, Antimitochondrial antibody, Liver histopathology

CHENG Ya-jiao, LU Guan-zhu, WANG Yu-huan, BAO Yu-jie, XU Jie, YUAN Xiao-ling. An analysis for the diagnostic?significance of clinical manifestation, autoantibodies and liver pathology of 84 patients with primary biliary cholangitis[J]. Chinese Hepatolgy, 2022, 27(5): 566-569.

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