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Anti-gp210 and anti-centromere antibodies are different risk factors for the progression of primary biliary cirrhosis

2006; Lippincott Williams & Wilkins; Volume: 45; Issue: 1 Linguagem: Inglês

10.1002/hep.21472

1527-3350

Minoru Nakamura, Hisayoshi Kondo, Tsuyoshi Mori, Atsumasa Komori, Mutsumi Matsuyama, Masahiro Ito, Yasushi Takii, Makiko Koyabu, Terufumi Yokoyama, Kiyoshi Migita, Manabu Daikoku, Seigo Abiru, Hiroshi Yatsuhashi, Eiichi Takezaki, Naohiko Masaki, Kazuhiro Sugi, Koichi Honda, Hiroshi Adachi, Hidehiro Nishi, Yukio Watanabe, Yoko Nakamura, Masaaki Shimada, Tatsuji Komatsu, Akira Saito, Takeo Saoshiro, Hideharu Harada, Takeshi Sodeyama, Shigeki Hayashi, Akihide Masumoto, Takehiro Sando, Tetsuo Yamamoto, Hironori Sakai, Masakazu Kobayashi, Toyokichi Muro, Michiaki Koga, Zakera Shums, Gary L. Norman, Hiromi Ishibashi,

Systemic Lupus Erythematosus Research

The predictive role of antinuclear antibodies (ANAs) remains elusive in the long-term outcome of primary biliary cirrhosis (PBC). The progression of PBC was evaluated in association with ANAs using stepwise Cox proportional hazard regression and an unconditional stepwise logistic regression model based on the data of 276 biopsy-proven, definite PBC patients who have been registered to the National Hospital Organization Study Group for Liver Disease in Japan (NHOSLJ). When death of hepatic failure/liver transplantation (LT) was defined as an end-point, positive anti-gp210 antibodies (Hazard ratio (HR) = 6.742, 95% confidence interval (CI): 2.408, 18.877), the late stage (Scheuer's stage 3, 4) (HR = 4.285, 95% CI:1.682,10.913) and male sex (HR = 3.266, 95% CI: 1.321,8.075) were significant risk factors at the time of initial liver biopsy. When clinical progression to death of hepatic failure/LT (i.e., hepatic failure type progression) or to the development of esophageal varices or hepatocellular carcinoma without developing jaundice (Total bilirubin < 1.5 mg/dL) (i.e., portal hypertension type progression) was defined as an end-point in the early stage (Scheuer's stage 1, 2) PBC patients, positive anti-gp210 antibodies was a significant risk factor for hepatic failure type progression [odds ratio (OR) = 33.777, 95% CI: 5.930, 636.745], whereas positive anti-centromere antibodies was a significant risk factor for portal hypertension type progression (OR = 4.202, 95% CI: 1.307, 14.763). Histologically, positive anti-gp210 antibodies was most significantly associated with more severe interface hepatitis and lobular inflammation, whereas positive anticentromere antibodies was most significantly associated with more severe ductular reaction. Conclusion: These results indicate 2 different progression types in PBC, hepatic failure type and portal hypertension type progression, which may be represented by positive-anti-gp210 and positive-anticentromere antibodies, respectively. (Hepatology 2007;45:118–127.)