Clinical Gastroenterology Vol.18 No.5(4-2)

Theme Primary Biliary Cirrhosis : update 2003
Title Long-term Prognosis for Primary Biliary Cirrhosis (PBC) in Japan and Analysis of Factors Related to Stage Progression
Publish Date 2003/05
Author Toshiaki Nakano Division of Medical Informatics, University Information Center, Kansai Medical University
Author Junko Hirohara Third Department of Internal Medicine, Kansai Medical University
Author Seizaburou Arita Department of Mathematics, Kansai Medical University
[ Summary ] Based on data from a national survey (survey period: 1980-2001) of primary biliary cirrhosis (PBC), the pathology and prognosis of PBC in Japan were both elucidated. There were no significant differences in clinical findings from those in previous reports. The five year survival rates for patients with a-PBC, s1-PBC, and s2-PBC at the time of diagnosis were 97%, 89%, and 54%, respectively, showing that the survival rate of patients with s2-PBC was slightly improved in relation to previous study. As a result of examining changes in the prognoses for PBC patients, there was a significant difference between the 1980s groups and 1990s groups for a-PBC, s1-PBC and mild and/or moderate s2-PBC. Patients with a-PBC at the time of diagnosis were divided into groups: those in whom the disease progressed to s2-PBC and did not progress to s2-PBC at the final examination. Prognoses were compared between the groups. The prognoses were significantly poorer in the s2-PBC progression group. As a result of multivariate analysis for prediction of prognoses, levels at diagnosis of total serum bilirubin, albumin, total cholesterol, histological stage, and presence or absence of ursodeoxycholic acid (UDCA) administration were selected as significant factors, considered useful as early prognostic indicators in patients diagnosed as having a-PBC whose prognosis might deteriorate and progress to s2-PBC.
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