Saffioti, F;
Hall, A;
de Krijger, M;
Verheij, J;
Hubscher, SG;
Maurice, J;
Tu, VL;
... Thorburn, D; + view all
(2021)
Collagen proportionate area correlates with histological stage and predicts clinical events in primary sclerosing cholangitis.
Liver International
, 41
(11)
pp. 2681-2692.
10.1111/liv.14979.
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Abstract
Background & Aims: Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease in need of accurate biomarkers for stratification and as surrogates for clinical endpoints in trials. Quantitative liver fibrosis assessment by collagen proportionate area (CPA) measurement has been demonstrated to correlate with clinical outcomes in chronic hepatitis C, alcohol-related and non-alcoholic fatty liver disease. We aimed to investigate the ability of CPA to quantify liver fibrosis and predict clinical events in PSC. Methods: Biopsies from 101 PSC patients from two European centres were retrospectively assessed by two expert pathologists in tandem, using grading (Ishak and Nakanuma) and staging (Ishak, Nakanuma, Ludwig) systems recently validated to predict clinical events in PSC. CPA was determined by image analysis of picro-Sirius red-stained sections following a standard protocol. We assessed the correlations between CPA, staging and grading and their associations with three outcomes: (1) time to PSC-related death, liver transplant or primary liver cancer; (2) liver transplant-free survival; (3) occurrence of cirrhosis-related clinical manifestations. Results: CPA correlated strongly with histological stage determined by each scoring system (P < .001) and was significantly associated with the three endpoints. Median time to endpoint-1, endpoint-2 and endpoint-3 was shorter in patients with higher CPA, on Kaplan-Meier analyses (P = .011, P = .034 and P = .001, respectively). Conclusion: Quantitative fibrosis assessment by CPA has utility in PSC. It correlates with established histological staging systems and predicts clinical events. CPA may be a useful tool for staging fibrosis and for risk stratification in PSC and should be evaluated further within prospective clinical trials.
| Type: | Article |
|---|---|
| Title: | Collagen proportionate area correlates with histological stage and predicts clinical events in primary sclerosing cholangitis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/liv.14979 |
| Publisher version: | https://doi.org/10.1111/liv.14979 |
| 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. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Gastroenterology & Hepatology, collagen proportionate area, digital image analysis, primary sclerosing cholangitis, quantitative fibrosis assessment, risk stratification, DOSE URSODEOXYCHOLIC ACID, TRANSPLANT-FREE SURVIVAL, DIGITAL IMAGE-ANALYSIS, LIVER FIBROSIS SCORE, PROGNOSTIC VALUE, CIRRHOSIS, DECOMPENSATION, PROGRESSION, OUTCOMES, DISEASE |
| 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/10142274 |
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