In clinical practice, many middle-aged and elderly women, in the occasional physical examination or because of other diseases laboratory tests found alkaline phosphatase (ALP) or r-glutamyl transferase (r-GT) is elevated, you should not at this time to a “no matter” or “may be cholecystitis, gallstone disease “You should never tell a patient that he or she may have primary biliary cirrhosis (PBC) even if he or she does not have any symptoms. Primary biliary cirrhosis (PBC) is a chronic progressive cholestatic liver disease of unknown etiology. Its pathological changes are mainly characterized by chronic non-suppurative destruction of small intrahepatic bile ducts, inflammation of the confluent area, chronic biliary stasis, liver fibrosis, and eventually development of cirrhosis and liver failure The disease is mostly seen in middle-aged women, with 85% to 90% of patients aged 40 to 60 years. The onset of the disease is insidious and slow. Early symptoms are lacking or mild, and weakness, itchy skin, jaundice and liver discomfort are common symptoms of the disease. Some patients may also have clinical manifestations of autoimmune diseases such as dry mouth and eyes, Raynaud’s sign, joint pain and other dry syndrome, scleroderma and rheumatoid arthritis. M2 AMA is specific for the diagnosis of this disease; about 50% of PBC patients can have positive anti-nuclear antibodies, mainly anti-GP210S and anti-SP100. Histological examination of liver biopsy can help the definite diagnosis and staging of the disease. There is no specific treatment for the disease, which is mainly symptomatic and supportive. Ursodeoxycholic acid (UDCA) is a drug that does have efficacy in this disease. It reduces the hepatotoxicity of endogenous bile acids, protects the hepatocyte membrane, increases the secretion of endogenous bile acids and has immunomodulatory effects. The later stages of the disease require liver transplantation. Therefore, clinically, the disease should be considered in women of middle age or older with a chronic course, significant skin pruritus, jaundice, hepatomegaly, and biochemical changes of cholestatic jaundice without evidence of extrahepatic bile duct obstruction, and further investigations may be performed to confirm the diagnosis. The American Association for the Study of Liver Diseases recommends the following diagnostic criteria: (1) biochemical indicators of cholestasis, such as alkaline phosphatase, have been elevated for more than 6 months; (2) ultrasound or cholangiography shows normal bile ducts; (3) positive AMA or AMA-M2 subtype; (4) if serum AMA/AMA-M2 is negative, histological examination by liver puncture is consistent with PBC.