Abstract: Objective The aim of this study was to investigate the predictive performance of transient elastography (TE)and other common non-invasive diagnostic models in predicting histological fibrosis staging in patients with primary biliary cholangitis (PBC). Methods This study enrolled 117 patients with PBC in Beijing You’an Hospital, affiliated to Capital Medical University between January 2019 and August 2023, and all patients underwent liver biopsy and liver stiffness measurement (LSM). The aspartate aminotransferase/platelet ratio (APRI), fibrosis index based on the four factors (FIB-4), gamma-glutamyl transferase to platelet ratio (GPR), Sheth index, King's score, Gotebörg university cirrhosis index (GUCI) score,albumin-bilirubin (ALBI) score, total bile acid - red cell volume distribution width (TR) score were calculated. The ROC curve analysis was conducted to evaluate the predictive efficacy of each index. Results Out of the 117 patients with PBC, the histo-pathological examination showed stage I in 17 cases, stage II in 59 cases, stage III in 34 cases and stage IV in 7 cases; the AUC was 0.875(0.776-0.974) by APRI in predicting the stage II and the above disease, with the sensitivity(Se), specificity(Sp), positive predictive value (PPV) and negative predictive value (NPV) of 75.8%, 87.5%, 76.5% and 87.0%, and the other relatively promising index was the GUCI score, with the AUC of 0.871(0.766-0.976), and Se, Sp, PPV and NPV of 88.7%, 75.0%, 65.6% and 92.4%, respectively. Conclusion The APRI is a simple and inexpensive non-invasive index with a good diagnostic efficacy in predicting stage II or above PBC patients, which needs further clinical investigation.

Key words: Primary biliary cholangitis, Non-invasive diagnostic model, Transient elastography, Liver fibrosis, Diagnosis