Objective To explore the correlation between AST/platelet ratio index (APRI) and progression to adverse outcomes in primary biliary cholangitis (PBC). Methods The clinical data of 123 PBC patients admitted to the First Affiliated Hospital of Anhui Medical University from January 2008 to May 2018 were retrospectively analyzed. The correlation between APRI and PBC histological stage was analyzed by Spearman's rank correlation test.The correlation between APRI, AST, reciprocal of platelet count and PBC adverse outcomes was assessed emphatically. The optimal cut-off values for predicting adverse outcomes were determined by receiver operating characteristic (ROC) analysis. The index with the largest area under curve (AUC) was selected to analyze its correlation with the prognosis of PBC patients. Results In a total of 123 patients with PBC, 28 had adverse outcomes, including 7 with liver transplantation and 21 with hepatic disease-related deaths. Spearman rank correlation analysis revealed a positive correlation between APRI and PBC liver histological stages (Rs=0.552, P<0.001). The AUC of APRI, AST and 1/PLT for predicting the PBC adverse outcomes was 0.84 (0.75~0.93), 0.76 (0.66~0.86) and 0.81 (0.71~0.91), respectively. The cut-off value was 1.33, 90.5 and 0.007 6×109/L, respectively. The sensitivity of APRI>1.33, AST>90.5, 1/PLT>0.007 6×109/L for predicting PBC adverse outcomes was 85.71%, 75.00% and 71.43%, respectively, and the specificity was 76.84%, 81.05% and 76.84%, respectively.The positive predictive value was 52.17%, 53.85% and 47.62%, respectively, and and negative predictive value was 94.81%, 91.67% and 90.12%, respectively. The accuracy of prediction was 78.86%, 79.67% and 75.61%, respectively. APRI>1.33 group had a significantly lower survival rate compared with APRI ≤ 1.33 group (P<0.001).Conclusion APRI is positively correlated with histological disease progression in PBC patients. Elevated baseline APRI>1.33 is associated with an increased risk of adverse events in PBC. APRI appears to be a useful clinical assessment tool for PBC patients. |