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Cholangiocarcinoma is associated with a raised enhanced liver fibrosis (ELF) score independent of primary sclerosing cholangitis

Saffioti, F; Roccarina, D; Vesterhus, M; Hov, JR; Rosenberg, W; Pinzani, M; Pereira, SP; ... Thorburn, D; + view all (2019) Cholangiocarcinoma is associated with a raised enhanced liver fibrosis (ELF) score independent of primary sclerosing cholangitis. European Journal of Clinical Investigation , 49 (5) , Article e13088. 10.1111/eci.13088. Green open access

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Abstract

BACKGROUND: Cholangiocarcinoma (CCA) complicates primary sclerosing cholangitis (PSC) in 10-20% of cases, but current tools for prediction of a CCA diagnosis are inadequate. Recently we demonstrated the utility of the ELF test to stratify prognosis in PSC. We observed that patients with PSC+CCA had significantly higher ELF score than those with PSC alone. In this study, we aimed to investigate further this association in a larger cohort of PSC patients with CCA compared with patients with PSC or CCA alone. MATERIALS AND METHODS: Stored sera from patients with PSC (n=119), CCA without known chronic liver disease (n=36) and PSC+CCA (n=32) underwent ELF testing. ELF score, gender, age, age at disease diagnosis, inflammatory bowel disease, PSC duration and severity, and CCA features were compared amongst the three cohorts. Factors related to an elevated ELF score were investigated. RESULTS: ELF score was significantly higher in patients with CCA without underlying chronic liver disease and in patients with PSC+CCA compared to those with PSC alone (p<0.001). In multivariate analysis, elevated ELF score was associated with the diagnosis of CCA independently of age and PSC status (p<0.001). CONCLUSIONS: ELF score was elevated in patients with CCA irrespective of the presence of PSC, and independently of liver disease stage. Our results indicate that the association between high ELF score and CCA may be related to the tumour's desmoplastic nature, independent of background liver fibrosis, suggesting that ELF score could be used to risk stratify for CCA in PSC. This article is protected by copyright.

Type: Article
Title: Cholangiocarcinoma is associated with a raised enhanced liver fibrosis (ELF) score independent of primary sclerosing cholangitis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/eci.13088
Publisher version: http://doi.org/10.1111/eci.13088
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
URI: https://discovery.ucl.ac.uk/id/eprint/10068817
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