FibroScan i evalueringen av sykdomsprogresjon hos pasienter med primær biliær cirrhose. : Sammenlikning med ikke-invasive biokjemiske markører og symptomscore.

Abstract

Aim: To examine if patients with Primary Biliary Cirrhosis progress in liver fibrosis despite treatment with ursodeoxycholic acid (UrsoFalk), and to study correlations between liver fibrosis measured by transient elastography (FibroScan) and biochemical markers of fibrosis.

Methods: We invited 24 patients with PBC to a study consultation containing blood samples, FibroScan examination and interview. We also collected information from the patients´ files.

Results: We included 16 patients with biopsy result from the time of diagnosis and valid FibroScan measurement from the study consultation. Four patients had progressed. Three of these patients had had PBC for more than seven years. The patients in the progression group had a mean duration of disease of 14 years, compared to 7,5 years in the group without progression (p-value 0,11). We achieved valid FibroScan measurements from 21 patients. Liver fibrosis measured by FibroScan had statistically significant correlations with the following variables: Age, duration of disease, thrombocytes, APRI-score and Fib-4 (strongest correlation with Spearmans rho 0,598 and p-value 0,004).

Discussion: The difference in progression rate between the groups with short and long duration of disease gives us an indication (with statistically non-significant data) that patients with PBC progress in liver fibrosis as time goes by, in spite of therapy. This is supported by the statistically significant correlations between the FibroScan values and the variables “age” and “duration of disease”. The relatively strong correlation to Fib-4 is interesting, but further studies are needed to establish its clinical value.