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BACKGROUNDOesophageal varices (EV) development is among the major complications of liver cirrhosis. Therefore, the current guidelines recommend screening of all liver cirrhosis patients for EV by endoscopy, but repeated endoscopic examinations are unpleasant for the patients, are not cost-effective and pose additional burden to endoscopic units. Therefore, non-invasive predictors of EV have been studied.The aim is to comparatively evaluate platelet count/spleen diameter (PC/SD) ratio, right liver lobe diameter (RLLD)/albumin ratio & left liver lobe diameter (LLLD)/albumin ratio as the non-invasive predictors of EV & their grading in patients with liver cirrhosis. MATERIALS AND METHODSThis study included 100 patients of liver cirrhosis which were subjected to laboratory investigations including platelet count & serum albumin concentration, abdominal ultrasound including measurement of RLLD, LLLD & spleen diameter and upper gastrointestinal endoscopy. PC/SD ratio, RLLD/albumin ratio & LLLD/albumin ratio were then calculated & comparatively evaluated statistically for their correlation with the presence & grading of EV. RESULTSPC/SD ratio, RLLD/albumin ratio and LLLD/albumin ratio had highly significant correlations with the presence and grading of EV (p<0.001 for each). The sensitivity, specificity and accuracy of PC/SD ratio in prediction of EV was 90.2%, 88.9% and 90% respectively at the best cut-off value of 1167.25 as calculated by applying receiver operating characteristic (ROC) curve. [AUC (Area under curve) =0.965]. The sensitivity, specificity and accuracy of RLLD/albumin ratio in prediction of EV was 74.4%, 94.4% and 78% respectively at the best cut-off value of 4.272 (AUC=0.835). The sensitivity, specificity and accuracy of LLLD/albumin ratio in prediction of EV was 89%, 83.3% and 88% respectively at the best cut-off value of 1.939 (AUC=0.931). PC/SD ratio, having the highest sensitivity, accuracy & area under ROC curve, was the best predictor of EV, followed by the LLLD/albumin ratio, which was further followed by RLLD/albumin ratio. CONCLUSIONPC/SD ratio, RLLD/albumin ratio & LLLD/albumin ratio are cost-effective noninvasive parameters that can provide accurate information pertinent to predict the presence & grading of EV in liver cirrhosis patients & amongst them PC/SD ratio is the b est predictor of EV, followed by LLLD/albumin ratio, which is further followed by RLLD/albumin ratio. KEYWORDSLeft Liver Lobe Diameter/Albumin Ratio, Platelet Count, Right Liver Lobe Diameter/Albumin Ratio, Spleen Diameter, Upper Gastrointestinal Endoscopy. HOW TO CITE THIS ARTICLE: Charan S, Garg R, Chander R, et al. A comparative evaluation of liver lobe size/albumin ratio and platelet count/spleen diameter ratio as non-invasive predictors of oesophageal varices in patients with liver cirrhosis.

The 3-D reconstruction of conventional transrectal ultrasonography imaging is superior to 2-D imaging for staging localized prostate cancer. However, this advantage relies entirely on the visibility of prostate cancer lesions on conventional ultrasonography. Further studies are warranted to evaluate this technology for the management of prostate cancer.