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Liver Tests Fail to Measure Up to CPS II in Biliary Cirrhosis
A DGReview of :"Quantitative testing of liver function compared to prognostic scores in patients with primary biliary cirrhosis"
Liver
06/14/2002
By Mark Pownall
The best method of measuring the progress of primary biliary cirrhosis is the established Christiansen prognosis score (CPS), a comparison of different measures has concluded.
But, the comparison also indicates that the second version of the prognosis score, CPS II, is a better measure of disease progression.
A proposed alternative method of assessing prognosis using quantitative tests of liver function, did not appear to be as sensitive to change as CPS II.
Researchers from the University of Erlangen-Nuernberg in Germany followed 34 patients with primary biliary cirrhosis over two years. At the beginning of the study, the patients were investigated with CPS I and II, and the Mayo prognosis score. They also had serum levels of a surrogate marker for hepatic fibrogenesis (PIINP) measured, as well as other parameters relevant to primary biliary cirrhosis, and quantitative tests of liver function. The patients also underwent histological staging of their condition.
The liver tests carried out included the aminopyrine breath test, galactose elimination capacity, and sorbitol and indocyanine green clearance. The tests were repeated after two years. Bilirubin, serum IgM and PIINP were raised at both times of measurement, but albumin and prothrombin levels remained normal.
Clinical findings of ascites, cirrhosis and central cholestasis were worse after two years, as was histological staging. Despite this progression of disease, the liver tests CPS I and Mayo scores barely changed.
The researchers concluded that the quantitative liver tests and the measurement of the fibrogenesis marker added nothing to assessment of progression of the biliary cirrhosis over two years, and that CPS II is better for measurement of prognosis in the short term.
Liver 2002; 22(2): 159-165.
"Quantitative testing of liver function compared to prognostic scores in patients with primary biliary cirrhosis"
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