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Minerva Gastroenterologica e Dietologica 2020 Dec 10
DOI: 10.23736/S1121-421X.20.02821-4
Copyright © 2020 EDIZIONI MINERVA MEDICA
language: English
Risk stratification in primary sclerosing cholangitis
Giacomo MULINACCI 1, 2, Laura CRISTOFERI 1, 2, Andrea PALERMO 1, 2, Martina LUCÀ 1, 2, Alessio GERUSSI 1, 2, Pietro INVERNIZZI 1, 2, Marco CARBONE 1, 2 ✉
1 Division of Gastroenterology, Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy; 2 European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
Primary Sclerosing Cholangitis (PSC) is a chronic liver disorder commonly affecting young patients and associated with uncertain prognosis and elevated risk of end-stage liver disease and hepatobiliary cancer. Rate of progression in PSC is heterogeneous and accurately predicting the disease course is of paramount importance to clinical practice and interventional trial design. So far, efforts have brought to the development of models looking at short-to-middle-term outcome using composite models including clinical, laboratory, radiological and histological parameters with limited performance. In the era of whole genome sequencing and digital innovation, the time is ripe for the development of stratified medicine in PSC. Efforts should be directed toward developing wellphenotyped cohorts of patients with longitudinal follow-up across sustained periods of time, application of novel image-processing technology, and biomarker discovery using multi-omics platforms.
KEY WORDS: PSC; Risk-stratification; Biomarkers; Imaging