Introduction In PSC it has been believed that staging fibrosis is unhelpful due to the patchy nature of the condition, hence liver biopsy is rarely performed. Emerging data indicates that TE correlates well with fibrosis stage on liver histology and that both TE and the ELF test provide prognostic information in PSC. Thus far there has been no direct comparison of ELF testing and TE. Here we present a comparison of clinical scores, TE and the ELF test in patients with PSC.
Method Patients with large-duct PSC had TE [Fibroscan® (Echosens): 10 valid measurements and a success rate >60% after 3 hrs fasting] and serum stored at the same visit to the Royal Free, London and the Hospital Clínic, Barcelona (Jun 2010–Feb 2015). Full patient demographics and clinical outcomes were recorded. Clinical scores of disease severity (APRI and Mayo risk score) were obtained on the day of assessment. Stored sera were tested for ELF [ADVIA Centauro® XP system (Siemens Diagnostics). Spearman–s rank correlation was used due to the non-normal distribution of measures.
Results 39 [1 autoimmune overlap, 28(72%) male] PSC patients [mean (±SD): age 50(±14) yrs; age at diagnosis 42(±14) yrs; time from diagnosis of 7.8(±7.1) yrs] were evaluated. 28 patients (80%) were diagnosed with IBD: 21 ulcerative colitis, 6 Crohn’s disease, 1 indeterminate colitis. There were no significant differences in ELF, TE or age between UK and Barcelona patients. Fibroscan correlated with ELF with a Spearman–s rho 0.676 p < 0.001. Similarly, a strong correlation for both ELF and Fibroscan with Mayo [rho 0.836 (p < 0.001) and rho 0.771 (p < 0.001), respectively] and APRI [rho 0.766 (p < 0.001) and rho 0.755 (p < 0.001), respectively] scores was found.
Conclusion A significant correlation between liver stiffness measured by TE, ELF test, APRI and Mayo risk score is here demonstrated for the first time in patients with PSC. Our results suggest that while the process of fibrosis progression in PSC is poorly understood, non-invasive tests validated in other chronic liver diseases perform consistently in patients affected and should be further evaluated as tools for staging the disease, monitoring disease progression and prognosis and may provide much needed surrogate end points for clinical trials in PSC.
Disclosure of interest F. Saffioti: None Declared, M. Vesterhus: None Declared, A. Telese: None Declared, G. Mazza: None Declared, D. Roccarina: None Declared, M. Rosselli: None Declared, W. Jonasson: None Declared, A. Parés: None Declared, T. Karlsen: None Declared, W. Rosenberg: None Declared, M. Pinzani: None Declared, A. Marshall: None Declared, D. Thorburn Grant/Research Support from: Boston Scientific to fund a clinical research fellow.
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