| Objective To explore the association between AST/platelet ratio index (APRI) and progression to adverse outcomes in primary biliary cholangitis (PBC).
Methods From January 2008 to November 2018,123 cases of PBC patients who treated in our hospital were collected and analyzed. among them 46 received liver biopsy. Spearman’s rank correlation coefficient test between baseline APRI with histological stage in PBC. The correlation of APRI, AST, reciprocal of platelet count and PBC adverse events was assessed emphatically, Receiver operating characteristic (ROC) analysis was performed to determine the optimal cut-off values for predicting endpoint events , respectively. the AUC area was the largest indicator, and the survival rate of PBC without endpoint events was further analyzed by LogRank test.
Results Of the 123 patients with PBC, 28 patients with adverse outcomes, among them 7 patients required liver transplantation (LT) whereas a further 21 patients died liver-related death. APRI positively correlated with histological disease progression(rs=0.55, P＜0.001, Spearman’s rank correlation coefficient test). APRI, AST and 1/PLT predicted the area under the ROC curve of the PBC endpoint events (AUROC) was 0.84 ((95% confidence interval (CI) 0.75-0.93), 0.76 ((95% confidence interval (CI) 0.66-0.86) and 0.81 ((95% confidence interval (CI) 0.71-0.91), and the optimal cut-off values were 1.33, 90.5 and 0.0076, respectively. The sensitivity and specificity of PBC were 85.71%, 75.00%, 71.43%, 76.84%, 81.05% and 76.84 respectively.The positive and negative predictive values were 52.17%, 53.85%, 47.62%, 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 than APRI≤1.33group (P < 0.0001).
Conclusions APRI positively correlated with histological disease progression in PBC patients, elevated baseline APRI(APRI>1.33) is associated with an increased risk of adverse events in PBC. APRI appears to be a useful tool in the clinical assessment of patients with PBC.