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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 3
Mar.  2022
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Article Contents

Pathological staging systems of primary biliary cholangitis

DOI: 10.3969/j.issn.1001-5256.2022.03.033
Research funding:

Liaoning Provincial Science and Technology Project (2019JH2/10300031);

National Science and Technology Major Project during the 13th Five-Year Plan Period (2017ZX10103007)

More Information
  • Corresponding author: SHAO Chen, shaochen83@126.com(ORCID:0000-0002-7914-5493); DENG Baocheng, sydengbc@163.com(ORCID:0000-0003-4825-9794)
  • Received Date: 2021-07-11
  • Accepted Date: 2021-08-16
  • Published Date: 2022-03-20
  • Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease accompanied by cholestasis, with the histological feature of non-purulent cholangitis. This article briefly describes the advantages and limitations of the traditional pathological staging systems such as Rubin stage, Scheuer stage, and Ludwig stage and the latest Nakanuma stage. Among them, Nakanuma stage refines the histological grading and staging standards to reduce the chance of missed diagnosis due to sampling errors, thus providing more adequate diagnostic and prognostic information for the clinic. A combination of new and traditional staging systems can provide guidance to the diagnosis, treatment, and research of PBC.

     

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  • [1]
    KAPLAN MM, GERSHWIN ME. Primary biliary cirrhosis[J]. N Engl J Med, 2005, 353(12): 1261-1273. DOI: 10.1056/NEJMra043898.
    [2]
    LINDOR KD, BOWLUS CL, BOYER J, et al. Primary biliary cholangitis: 2018 Practice Guidance from the American Association for the study of liver diseases[J]. Hepatology, 2019, 69(1): 394-419. DOI: 10.1002/hep.30145.
    [3]
    TSUNEYAMA K, BABA H, MORIMOTO Y, et al. Primary biliary cholangitis: Its pathological characteristics and immunopathological mechanisms[J]. J Med Invest, 2017, 64(12): 7-13. DOI: 10.2152/jmi.64.7.
    [4]
    ZHANG P, XIAO YQ, AO QF. Correlation between pathological staging and serum biochemical indexes of primary biliary cholangitis[J]. Med Innov Chin, 2021, 18(15): 11-15. DOI: 10.3969/j.issn.1674-4985.2021.15.003.

    章萍, 肖影群, 敖琴芳. 原发性胆汁性胆管炎病理分期与各血清生化指标的相关性研究[J]. 中国医学创新, 2021, 18(15): 11-15. DOI: 10.3969/j.issn.1674-4985.2021.15.003.
    [5]
    PRINCE M, CHETWYND A, NEWMAN W, et al. Survival and symptom progression in a geographically based cohort of patients with primary biliary cirrhosis: Follow-up for up to 28 years-ScienceDirect[J]. Gastroenterology, 2002, 123(4): 1044-1051. DOI: 10.1053/gast.2002.36027.
    [6]
    WEI F. Analysis of the clinical characteristics of patients with primary biliary cholangitis and the influencing factors of UDCA response rate[D]. Changchun: Jilin University, 2020.

    魏凡. 原发性胆汁性胆管炎患者的临床特征分析及UDCA应答率的影响因素分析[D]. 长春: 吉林大学, 2020.
    [7]
    SILVEIRA MG, LINDOR KD. Obeticholic acid and budesonide for the treatment of primary biliary cirrhosis[J]. Expert Opin Pharmacother, 2014, 15(3): 365-372. DOI: 10.1517/14656566.2014.873404.
    [8]
    LEUNG J, BONIS PA, KAPLAN MM. Colchicine or methotrexate, with ursodiol, are effective after 20 years in a subset of patients with primary biliary cirrhosis[J]. Clin Gastroenterol Hepatol, 2011, 9(9): 776-780. DOI: 10.1016/j.cgh.2011.05.010.
    [9]
    RAUTIAINEN H, KRKKINEN P, KARVONEN AL, et al. Budesonide combined with UDCA to improve liver histology in primary biliary cirrhosis: A three-year randomized trial[J]. Hepatology, 2005, 41(4): 747-752. DOI: 10.1002/hep.20646.
    [10]
    YANG YF, DENG ZH. Immune mechanism of biliary epithelial cell injury in the small intrahepatic bile ducts in primary biliary cholangitis[J]. J Clin Hepatol, 2021, 37(6): 1466-1468. DOI: 10.3969/j.issn.1001-5256.2021.06.051.

    杨雅斐, 邓志华. 原发性胆汁性胆管炎肝内小胆管上皮细胞损伤的免疫学机制[J]. 临床肝胆病杂志, 2021, 37(6): 1466-1468. DOI: 10.3969/j.issn.1001-5256.2021.06.051.
    [11]
    YANG XL, ZHUANG L, HE HY, et al. Correlation between serum indexes and pathological stages in patients with PBC, and Logistic regression analysis on risk factors of patients with advanced PBC[J]. Chin J Gastroenterol Hepatol, 2019, 28(10): 1157-1161. DOI: 10.3969/j.issn.1006-5709.2019.10.014.

    杨晓玲, 庄琳, 和海玉, 等. PBC患者血清学指标与肝组织活检病理分期的关系及进展期PBC危险因素的Logistic回归分析[J]. 胃肠病学和肝病学杂志, 2019, 28(10): 1157-1161. DOI: 10.3969/j.issn.1006-5709.2019.10.014.
    [12]
    Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Consensus on the diagnosis and management of primary biliary cirrhosis (cholangitis)(2015)[J]. J Clin Hepatol, 2015, 31(12): 1980-1988. DOI: 10.3969/j.issn.1001-5256.2015.12.004.

    中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会. 原发性胆汁性肝硬化(又名原发性胆汁性胆管炎)诊断和治疗共识(2015)[J]. 临床肝胆病杂志, 2015, 31(12): 1980-1988. DOI: 10.3969/j.issn.1001-5256.2015.12.004.
    [13]
    RUBIN E, SCHAFFNER F, POPPER H. Primary biliary cirrhosis. chronic non-suppurative destructive cholangitis[J]. Am J Pathol, 1965, 46(3): 387-407. http://europepmc.org/articles/PMC1920366?pdf=render
    [14]
    SCHEUER P. Primary biliary cirrhosis[J]. Proc R Soc Med, 1967, 60(12): 1257-1260.
    [15]
    LUDWIG J, DICKSON ER, MCDONALD GS. Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis)[J]. Virchows Arch A Pathol Anat Histol, 1978, 379(2): 103-112. DOI: 10.1007/BF00432479.
    [16]
    NAKANUMA Y, ZEN Y, HARADA K, et al. Application of a new histological staging and grading system for primary biliary cirrhosis to liver biopsy specimens: Interobserver agreement[J]. Pathol Int, 2010, 60(3): 167-174. DOI: 10.1111/j.1440-1827.2009.02500.x.
    [17]
    LINDOR KD, GERSHWIN ME, POUPON R, et al. Primary biliary cirrhosis[J]. Hepatology, 2009, 50(1): 291-308. DOI: 10.1002/hep.22906
    [18]
    European Association for the Study of the Liver. EASL clinical practice guidelines: The diagnosis and management of patients with primary biliary cholangitis[J]. J Hepatol, 2017, 67(1): 145-172. DOI: 10.1016/j.jhep.2017.03.022.
    [19]
    KAKUDA Y, HARADA K, SAWADA-KITAMURA S, et al. Evaluation of a new histologic staging and grading system for primary biliary cirrhosis in comparison with classical systems[J]. Hum Pathol, 2013, 44(6): 1107-1117. DOI: 10.1016/j.humpath.2012.09.017.
    [20]
    MIAO Q. Clinical histopathological study of autoimmune liver disease[D]. Shanghai: Shanghai Jiao-Tong University, 2014.

    苗琪. 自身免疫性肝病临床病理组织学研究[D]. 上海: 上海交通大学, 2014.
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