{
  "abstract": "Introduction Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic liver disease that can progress to advanced fibrosis, cirrhosis, and portal hypertension. While histological assessment can aid fibrosis staging, liver biopsy is limited by invasiveness, cost, sampling variability, and potential complications, which restricts its use in routine practice and underscores the need for simple noninvasive tools. This study evaluates the diagnostic accuracy of commonly available serum-based indices for detecting severe fibrosis in PBC.Methods We conducted a retrospective, descriptive, and analytical study in a gastroenterology department including patients diagnosed with PBC. The diagnostic performance of five serum indices: AST/ALT ratio (AAR), bilirubin-to-albumin ratio (BAR), AST-to-platelet ratio index (APRI), FIB-4, and the platelet ratio–based index (TPR), for the detection of severe fibrosis (F3,F4) was evaluated using receiver operating characteristic (ROC) curves. Areas under the ROC curve, optimal cut-offs, and corresponding sensitivity and specificity were reported. Statistical significance was set at P<0.05.Results A total of 114 patients were analyzed; 108 (94.7%) were women, with a mean age of 50 ± 12.9 years. Diabetes was present in 10 (8.7%) patients, coeliac disease in 5 (4.3%), autoimmune thyroiditis in 21 (18.4%), and an overlap syndrome in 18 (15.7%). Asthenia was reported in 34 (29.8%), jaundice in 61 (53.5%), pruritus in 49 (42.9%), and clinical signs of portal hypertension in 30 (26.3%). Baseline laboratory values were: AST 65.5[44.5;107] IU/L, ALT 74[28;110] IU/L, GGT 115 [87.5;246] IU/L, ALP 282 [190;431] IU/L, bilirubin 10 [6;38], and platelets 190,000 [123750;259000]/mm 3. Fibrosis assessment was available in 94 (82.4%) patients: 9 (7.8%) were staged F0, 21 (18.4%) F1, 30 (26.3%) F2, and 34(29.8%) F3-F4 (severe fibrosis). All patients received ursodeoxycholic acid (UDCA) at 13 mg/kg. Regarding prediction of severe fibrosis, the AUROCs of AAR, BAR, APRI, FIB-4, and TPR were all statistically significant (P<0.05) and were 0.709, 0.812, 0.662, 0.750, and 0.809, respectively. BAR and TPR demonstrated the highest discriminative ability, with sensitivities of 76.1% and 82.7% and specificities of 82.3% and 73.3% respectively.Conclusions In this cohort of patients with PBC, simple serum-based indices showed clinically useful performance for identifying severe fibrosis. Among the evaluated scores, BAR and TPR demonstrated the best diagnosis performance among the evaluated scores, while FIB-4 provided intermediate accuracy and AAR and APRI showed more modest performance. These readily applicable biomarkers may support noninvasive risk stratification and help prioritize patients for closer monitoring and further fibrosis assessment; however, external validation in independent cohorts is warranted before routine implementation.",
  "authors": [
    {
      "affiliations": [
        "Medecine C Hepatogastroenterology Departement, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy of Rabat., Rabat, Morocco"
      ],
      "name": "Hamza Benazzouz"
    },
    {
      "affiliations": [
        "Medecine C Hepatogastroenterology Departement, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy of Rabat., Rabat, Morocco"
      ],
      "name": "Mohamed Borahma"
    },
    {
      "affiliations": [
        "Medecine C Hepatogastroenterology Departement, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy of Rabat., Rabat, Morocco"
      ],
      "name": "Fatimazahra Chabib"
    },
    {
      "affiliations": [
        "Medecine C Hepatogastroenterology Departement, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy of Rabat., Rabat, Morocco"
      ],
      "name": "Nawal Lagdali"
    },
    {
      "affiliations": [
        "Medecine C Hepatogastroenterology Departement, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy of Rabat., Rabat, Morocco"
      ],
      "name": "Fatimazahra Ajana"
    },
    {
      "affiliations": [
        "Medecine C Hepatogastroenterology Departement, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy of Rabat., Rabat, Morocco"
      ],
      "name": "Maryeme Kadiri"
    }
  ],
  "title": "P67 Diagnostic accuracy of simple serum-based indices for detecting severe fibrosis in primary biliary cholangitis (PBC)",
  "uid": "59ef97f5-bce8-5d4d-90a6-f42bf6a37b8c"
}