title: Esophagogastric varices as a prognostic factor for the determination of clinical stage in patients with primary biliary cirrhosis.
abstract: BACKGROUND
  Primary biliary cirrhosis (PBC) is usually classified as either asymptomatic PBC (a-PBC) or symptomatic PBC (s-PBC). Although the proportion of a-PBC versus s-PBC patients has been consistently increasing, it is not clear whether the present criteria for the staging of PBC are optimal or not. We investigated the clinical stage of PBC patients from the standpoint of esophagogastric varices (EGV).
  
  
  METHODS
  One hundred and nine PBC patients were enrolled in this retrospective study. We investigated the clinical features of PBC based on laboratory data, histological stage, symptoms, and existence of EGV. In addition, the clinical course and prognosis in patients who were periodically followed up were also studied.
  
  
  RESULTS
  (1) EGV was detected in a-PBC patients, and there was no difference in the grade of EGV between a-PBC and s-PBC patients. (2) a-PBC patients with EGV had more liver damage than those without EGV, and a-PBC patients with EGV had a poorer prognosis than those without EGV. (3) Three of 11 patients who progressed from a-PBC to s-PBC within 3 years had EGV. (4) One of 3 a-PBC patients with EGV had progressed to s-PBC at 3-year follow-up.
  
  
  CONCLUSIONS
  These results indicate that EGV is one of the most important factors for evaluating PBC. Therefore, we would like to propose that a-PBC patients with EGV should either be included in the presently defined s-PBC class, or that new prognostic classes of PBC be created that include EGV as a prognostic factor.
authors.affiliation: Third Department of Internal Medicine, Ehime University School of Medicine, Shigenobu-cho Ehime 791-0295, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Takeshita
authors.forename: Teru
authors.initials: T
authors.lastname: Kumagi
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Matsui
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.forename: Shinya
authors.initials: S
authors.lastname: Furukawa
authors.forename: Yoshiou
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Bunzo
authors.initials: B
authors.lastname: Matsuura
authors.forename: Kojiro
authors.initials: K
authors.lastname: Michitaka
authors.forename: Norio
authors.initials: N
authors.lastname: Horiike
authors.forename: Morikazu
authors.initials: M
authors.lastname: Onji
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D004932:Esophageal and Gastric Varices / Q000209:etiology*; D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000145:classification* / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models