: Primary biliary cholangitis (PBC) prognosis can be assessed using baseline prognostic scores from routine lab tests, which help diagnose hepatic fibrosis stages and predict transplant-free survival.

: A total of 138 PBC patients diagnosed by liver biopsy were enrolled. The Scheuer score assessed liver fibrosis stages. ROC analysis evaluated the diagnostic ability of prognostic models for fibrosis staging. The Kaplan-Meier method was used to analyze the ability to discriminate transplant-free survival rates. The Univariate Cox analysis was used to compare the risks for transplant-free survival.

: The APRI, FIB4, ALBI, and Mayo scores can all distinguish stage 4 (cirrhosis) and stages 1-3 (non-cirrhosis state), stages 1-2 (non-advanced fibrosis), and stages 3-4 (advanced fibrosis) (p < 0.0001). The cut-off values of APRI, FIB4, ALBI and Mayo scores for the diagnosis of PBC cirrhosis (stage 4) were 1.136, 3.692, -2.006 and -1.872, respectively. The cut-off values for the diagnosis of PBC advanced fibrosis (stage ≥3) were 1.085, 2.394, -2.298 and -2.317. Each score can distinguish the transplant-free survival at the cut-off value, p < 0.05. In the cox analysis for transplant-free survival rates, the greatest hazard ratio was 6.3655, P=0.03,when the FIB4 score > 3.692.And when the ALBI score was > -2.298, the hazard ratio was 5.2725, P=0.035.

: The APRI, FIB4, ALBI and Mayo scores have good diagnostic potential for the stage of liver fibrosis in PBC patients, and then determining the transplant-free survival. FIB4 and ALBI scores have better predictive ability for transplant-free survival than other scores.