{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:11:49Z","timestamp":1791313909001,"version":"4.3.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":1157,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>The development of liver fibrosis markers in primary biliary cirrhosis (PBC) is needed to facilitate the assessment of its progression and the effectiveness of new therapies. Here, we investigated the potential usefulness of transient elastography (TE) in the noninvasive evaluation of liver fibrosis stage and disease progression in PBC. We performed, first, a prospective performance analysis of TE for the diagnosis of METAVIR fibrosis stages in a diagnostic cohort of 103 patients and, second, a retrospective longitudinal analysis of repeated examinations in a monitoring cohort of 150 patients followed-up for up to 5 years. All patients were treated with ursodeoxycholic acid. Diagnostic thresholds of liver stiffness in discriminating fibrosis stages \u2265F1, \u2265F2, \u2265F3, and =F4 were 7.1, 8.8, 10.7, and 16.9 kPa, respectively. TE showed high performance and was significantly superior to biochemical markers (e.g., aspartate aminotransferase [AST]\/platelet ratio, FIB-4, hyaluronic acid, AST\/alanine aminotransferase ratio, and Mayo score) in diagnosing significant fibrosis, severe fibrosis, or cirrhosis. Analysis of the monitoring cohort data set using generalized linear models showed the following: (1) an overall progression rate of 0.48 \u00b1 0.21 kPa\/year (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.02) and (2) no significant progression in patients with F0-F1, F2, or F3 stages, but a significant increase (4.06 \u00b1 0.72 kPa\/year; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001) in cirrhotic patients. A cut-off value of 2.1 kPa\/year was associated with an 8.4-fold increased risk of liver decompensations, liver transplantations, or deaths (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001, Cox regression analysis). <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> TE is one of the best current surrogate markers of liver fibrosis in PBC. Over a 5-year period, on-treatment liver stiffness appears stable in most noncirrhotic PBC patients, whereas it significantly increases in patients with cirrhosis. Progression of liver stiffness in PBC is predictive of poor outcome. (HEPATOLOGY 2012;56:198\u2013208)<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.25599","type":"journal-article","created":{"date-parts":[[2012,1,23]],"date-time":"2012-01-23T11:40:31Z","timestamp":1327318831000},"page":"198-208","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":315,"title":["Noninvasive elastography-based assessment of liver fibrosis progression and prognosis in primary biliary cirrhosis"],"prefix":"10.1097","volume":"56","author":[{"given":"Christophe","family":"Corpechot","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrice","family":"Carrat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armelle","family":"Poujol-Robert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farid","family":"Gaouar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Wendum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Chazouill\u00e8res","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raoul","family":"Poupon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-22-20241201","doi-asserted-by":"crossref","first-page":"291308","DOI":"10.1002\/hep.22906","article-title":"Primary biliary cirrhosis.","volume":"50","author":"Lindor","year":"2009","journal-title":"HEPATOLOGY"},{"key":"R2-22-20241201","first-page":"237267","article-title":"EASL Clinical Practice Guidelines: management of cholestatic liver diseases.","volume":"51","year":"2009","journal-title":"J Hepatol"},{"key":"R3-22-20241201","doi-asserted-by":"crossref","first-page":"157160","DOI":"10.1136\/gut.2008.156489","article-title":"Elastography for the noninvasive assessment of liver disease: limitations and future developments.","volume":"58","author":"Vizzutti","year":"2009","journal-title":"Gut"},{"key":"R4-22-20241201","first-page":"960974","article-title":"Performance of transient elastography for the staging of liver fibrosis: a metaanalysis.","volume":"134","author":"FriedrichRust","year":"2008","journal-title":"Gastroenterology"},{"key":"R5-22-20241201","doi-asserted-by":"crossref","first-page":"11181124","DOI":"10.1002\/hep.21151","article-title":"Assessment of biliary fibrosis by transient elastography in patients with PBC and PSC.","volume":"43","author":"Corpechot","year":"2006","journal-title":"HEPATOLOGY"},{"key":"R6-22-20241201","first-page":"441447","article-title":"Transient elastography to assess hepatic fibrosis in primary biliary cirrhosis.","volume":"27","author":"GomezDominguez","year":"2008","journal-title":"Aliment Pharmacol Ther"},{"key":"R7-22-20241201","doi-asserted-by":"crossref","first-page":"720728","DOI":"10.1007\/s00535-008-2225-2","article-title":"Transient elastography for measurement of liver stiffness measurement can detect early significant hepatic fibrosis in Japanese patients with viral and nonviral liver diseases.","volume":"43","author":"Obara","year":"2008","journal-title":"J Gastroenterol"},{"key":"R8-22-20241201","doi-asserted-by":"crossref","first-page":"296301","DOI":"10.1002\/hep.510280203","article-title":"Primary biliary cirrhosisautoimmune hepatitis overlap syndrome: clinical features and response to therapy.","volume":"28","author":"Chazouilleres","year":"1998","journal-title":"HEPATOLOGY"},{"key":"R9-22-20241201","doi-asserted-by":"crossref","first-page":"871877","DOI":"10.1002\/hep.22428","article-title":"Biochemical response to ursodeoxycholic acid and longterm prognosis in primary biliary cirrhosis.","volume":"48","author":"Corpechot","year":"2008","journal-title":"HEPATOLOGY"},{"key":"R10-22-20241201","doi-asserted-by":"crossref","first-page":"13611367","DOI":"10.1016\/j.jhep.2011.02.031","article-title":"Early primary biliary cirrhosis: biochemical response to treatment and prediction of longterm outcome.","volume":"55","author":"Corpechot","year":"2011","journal-title":"J Hepatol"},{"key":"R11-22-20241201","doi-asserted-by":"crossref","first-page":"4854","DOI":"10.1002\/hep.20506","article-title":"Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C.","volume":"41","author":"Ziol","year":"2005","journal-title":"HEPATOLOGY"},{"key":"R12-22-20241201","doi-asserted-by":"crossref","first-page":"518526","DOI":"10.1053\/jhep.2003.50346","article-title":"A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C.","volume":"38","author":"Wai","year":"2003","journal-title":"HEPATOLOGY"},{"key":"R13-22-20241201","doi-asserted-by":"crossref","first-page":"13171325","DOI":"10.1002\/hep.21178","article-title":"Development of a simple noninvasive index to predict significant fibrosis in patients with HIVHCV coinfection.","volume":"43","author":"Sterling","year":"2006","journal-title":"HEPATOLOGY"},{"key":"R14-22-20241201","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1002\/hep.1840100102","article-title":"Prognosis in primary biliary cirrhosis: model for decision making.","volume":"10","author":"Dickson","year":"1989","journal-title":"HEPATOLOGY"},{"key":"R15-22-20241201","doi-asserted-by":"crossref","first-page":"103112","DOI":"10.1007\/BF00432479","article-title":"Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis).","volume":"379","author":"Ludwig","year":"1978","journal-title":"Virchows Arch A Pathol Anat Histol"},{"key":"R16-22-20241201","doi-asserted-by":"crossref","first-page":"289293","DOI":"10.1002\/hep.510240201","article-title":"An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group.","volume":"24","author":"Bedossa","year":"1996","journal-title":"HEPATOLOGY"},{"key":"R18-22-20241201","doi-asserted-by":"crossref","first-page":"837845","DOI":"10.2307\/2531595","article-title":"Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach.","volume":"44","author":"Delong","year":"1988","journal-title":"Biometrics"},{"key":"R19-22-20241201","doi-asserted-by":"crossref","first-page":"635640","DOI":"10.1002\/hep.1840190314","article-title":"Predictive factors in ursodeoxycholic acidtreated patients with primary biliary cirrhosis: role of serum markers of connective tissue.","volume":"19","author":"Poupon","year":"1994","journal-title":"HEPATOLOGY"},{"key":"R20-22-20241201","doi-asserted-by":"crossref","first-page":"840845","DOI":"10.1111\/j.1478-3231.2006.01304.x","article-title":"The ASTALT ratio as an indicator of cirrhosis in patients with PBC.","volume":"26","author":"Nyblom","year":"2006","journal-title":"Liver Int"},{"key":"R21-22-20241201","doi-asserted-by":"crossref","first-page":"787797","DOI":"10.1111\/j.1478-3231.2008.01722.x","article-title":"Serological markers for monitoring disease progression in noncirrhotic primary biliary cirrhosis on ursodeoxycholic acid therapy.","volume":"28","author":"Farkkila","year":"2008","journal-title":"Liver Int"},{"key":"R22-22-20241201","doi-asserted-by":"crossref","first-page":"591594","DOI":"10.3748\/wjg.15.591","article-title":"Biochemical markers for noninvasive assessment of disease stage in patients with primary biliary cirrhosis.","volume":"15","author":"Alempijevic","year":"2009","journal-title":"World J Gastroenterol"},{"key":"R23-22-20241201","first-page":"491A","article-title":"The Toronto Western Hospital PBC Study: the AST to platelet ratio index (APRI) is an effective predictor of longterm outcome in patients with primary biliary cirrhosis.","volume":"52","author":"Meaney","year":"2010","journal-title":"HEPATOLOGY"},{"key":"R24-22-20241201","doi-asserted-by":"crossref","first-page":"828835","DOI":"10.1002\/hep.23425","article-title":"Pitfalls of liver stiffness measurement: a 5year prospective study of 13,369 examinations.","volume":"51","author":"Castera","year":"2010","journal-title":"HEPATOLOGY"},{"key":"R25-22-20241201","doi-asserted-by":"crossref","first-page":"720730","DOI":"10.1016\/j.clinre.2011.07.003","article-title":"FibroTest((R)) and Fibroscan((R)) performances revisited in patients with chronic hepatitis C. Impact of the spectrum effect and the applicability rate.","volume":"35","author":"Poynard","year":"2011","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"R26-22-20241201","doi-asserted-by":"crossref","first-page":"16881690","DOI":"10.1093\/clinchem\/37.10.1688","article-title":"Indocyanine greensulfobromophthalein pharmacokinetics for diagnosing primary biliary cirrhosis and assessing histological severity.","volume":"37","author":"Vaubourdolle","year":"1991","journal-title":"Clin Chem"},{"key":"R27-22-20241201","doi-asserted-by":"crossref","first-page":"187193","DOI":"10.1111\/j.1478-3231.2004.0918.x","article-title":"Biochemical markers of liver fibrosis and lymphocytic piecemeal necrosis in UDCAtreated patients with primary biliary cirrhosis.","volume":"24","author":"Corpechot","year":"2004","journal-title":"Liver Int"},{"key":"R28-22-20241201","doi-asserted-by":"crossref","first-page":"15491557","DOI":"10.1002\/hep.22517","article-title":"Prediction of clinical outcomes in primary biliary cirrhosis by serum enhanced liver fibrosis assay.","volume":"48","author":"Mayo","year":"2008","journal-title":"HEPATOLOGY"},{"key":"R29-22-20241201","doi-asserted-by":"crossref","first-page":"715720","DOI":"10.1053\/j.gastro.2005.12.029","article-title":"Excellent longterm survival in patients with primary biliary cirrhosis and biochemical response to ursodeoxycholic acid.","volume":"130","author":"Pares","year":"2006","journal-title":"Gastroenterology"},{"key":"R30-22-20241201","doi-asserted-by":"crossref","first-page":"12811287","DOI":"10.1053\/j.gastro.2009.01.003","article-title":"Improved prognosis of patients with primary biliary cirrhosis that have a biochemical response to ursodeoxycholic acid.","volume":"136","author":"Kuiper","year":"2009","journal-title":"Gastroenterology"},{"key":"R31-22-20241201","doi-asserted-by":"crossref","first-page":"21862194","DOI":"10.1038\/ajg.2010.216","article-title":"Baseline ductopenia and treatment response predict longterm histological progression in primary biliary cirrhosis.","volume":"105","author":"Kumagi","year":"2010","journal-title":"Am J Gastroenterol"},{"key":"R32-22-20241201","doi-asserted-by":"crossref","first-page":"652658","DOI":"10.1053\/gast.2002.31880","article-title":"Primary biliary cirrhosis: incidence and predictive factors of cirrhosis development in ursodioltreated patients.","volume":"122","author":"Corpechot","year":"2002","journal-title":"Gastroenterology"},{"key":"R33-22-20241201","doi-asserted-by":"crossref","first-page":"283287","DOI":"10.1016\/j.gcb.2010.02.004","article-title":"Triple therapy with ursodeoxycholic acid, budesonide and mycophenolate mofetil in patients with features of severe primary biliary cirrhosis not responding to ursodeoxycholic acid alone.","volume":"34","author":"Rabahi","year":"2010","journal-title":"Gastroenterol Clin Biol"},{"key":"R34-22-20241201","first-page":"14451449","article-title":"Now there are many (stages) where before there was one: in search of a pathophysiological classification of cirrhosis.","volume":"51","author":"GarciaTsao","year":"2010","journal-title":"HEPATOLOGY"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.25599","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-201207000-00022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T14:11:28Z","timestamp":1733062288000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-201207000-00022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,7]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2012]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.25599","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[2012,7]]}}}