Development and evaluation of a novel score for prediction of large oesophageal varices in patients with hepatitis c virus-induced liver cirrhosis

Kosari, Farid; Omran, M M; Farag, Raghda E.; Arafa, Mostafa A.; Emran, Tarek M.

doi:10.1080/09674845.2017.1297217

Cited by 11 publications

(8 citation statements)

References 27 publications

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“…Another study found that INR was correlated independently and significantly with liver fibrosis in chronic hepatitis C patients [16]. Recently, a study by Farid K et al [17] demonstrated that prothrombin-INR scores contributed to predicting the occurrence of large esophageal varices in patients with hepatitis C virus-induced liver cirrhosis. Therefore, the INR could be considered a potential indicator of liver fibrosis.…”

Section: Introductionmentioning

confidence: 98%

INR-to-platelet ratio (INPR) as a novel noninvasive index for predicting liver fibrosis in chronic hepatitis B

Ding¹,

Zheng²,

Huang³

et al. 2021

Int. J. Med. Sci.

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Objective: We aimed to investigate whether a novel noninvasive index, i.e., the international normalized ratio-to-platelet ratio (INPR), was a variable in determining liver fibrosis stage in patients with chronic hepatitis B (CHB). Methods: A total of 543 treatment-naïve CHB patients were retrospectively enrolled. Liver histology was assessed according to the Metavir scoring scheme. All common demographic and clinical parameters were analyzed. Results: Based on routine clinical parameters (age, sex, HBeAg status, HBV DNA, hematological parameters, coagulation index, and liver biochemical indicators), a novel index, i.e., the INR-to-platelet ratio (INPR), was developed to magnify the unfavorable effects of liver fibrosis on INR and platelets. The AUCs of INPR for predicting significant fibrosis, advanced fibrosis, and cirrhosis were 0.74, 0.76 and 0.86, respectively. Compared with APRI, FIB-4, and GPR, the INPR had comparable predictive efficacy for significant fibrosis and better predictive performance for advanced fibrosis and cirrhosis. Conclusion: INPR could be an accurate, easily calculated and inexpensive index to assess liver fibrosis in patients with CHB. Further studies are needed to verify this indicator and compare it with other noninvasive methods for predicting liver fibrosis in CHB patients.

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Section: Introductionmentioning

confidence: 98%

INR-to-platelet ratio (INPR) as a novel noninvasive index for predicting liver fibrosis in chronic hepatitis B

Ding¹,

Zheng²,

Huang³

et al. 2021

Int. J. Med. Sci.

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“…demonstrated that no association was found between esophageal varices and AST/ALT ratio and AST/ALT at a cut‐off 1.71, with 59% sensitivity, 54% specificity, and an AUC of 0.53. This could be attributable to the effect of several variables on serum ALT, such as gender and body mass index, as well as hepatotoxic medications, which subsequently affect AST/ALT results 26 …”

Section: Discussionmentioning

confidence: 99%

“…However, this was in disagreement with Sebastiani et al ., 23 who showed that for the Lok score at a cut‐off >1.5, used to predict PHG, sensitivity was 71.3%, specificity was 68.3%, PPV was 50%, NPV was 84.2%, and AUC was 0.42. In addition, Farid K and his colleague mentioned that the combination of Lok index and Forns' index had an AUC of 0.80 with 90% NPV to exclude large OV or small OV 26 …”

Section: Discussionmentioning

confidence: 99%

Accuracy of noninvasive tests in the prediction of portal hypertensive gastropathy in Egyptian patients with cirrhosis

et al. 2021

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Background and AimLiver cirrhosis (LC) is commonly associated with portal hypertensive gastropathy (PHG), and it causes gastrointestinal (GI) bleeding. Esophagogastroduodenoscopy (EGD) is the gold standard in diagnosing PHG. Besides its invasiveness, the disadvantages of EGD include psychological and financial problems. We aimed to evaluate the diagnostic accuracy of different noninvasive screening tools in predicting PHG.MethodsThis cross‐sectional study was conducted on 100 patients with LC who were divided into two groups based on EGD: group (A), 50 patients with LC with PHG, and group (B), 50 patients with LC without PHG. All patients were subjected to history taking, full clinical examination, laboratory investigations, abdominal–pelvic ultrasonography, and EGD.ResultsTo predict PHG, the respective sensitivity and specificity of portal vein diameter (>10.5 mm) were 86 and 67%, of gallbladder wall thickness (GBWT) (>3.5 mm) were 64 and 68%, of platelets/GBWT (<40) were 68 and 78%, of aspartate aminotransferase (AST)/platelet ratio index (APRI) score (>1.1) were 60 and 66%, of platelet/spleen diameter (<1290) were 88 and 72%, of right liver lobe diameter/albumin ratio (>4) were 74 and 80%, and of AST/alanine aminotransferase (ALT) ratio (>1.1) were 50 and 58% (P = 0.353).ConclusionPortal vein diameter, platelet/spleen diameter, and right liver lobe diameter/albumin ratio were independently associated with PHG and were good predictors of the PHG, whereas AST/ALT ratio and King score are poor predictors.

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“…To sum up, platelet parameters and related scoring systems such as PAP scores, AAR, APRI, GUCI, BRC score, Fibro-Alfa, FIB4, Lok, and Fibro-Q, have a certain value in predicting the degree of esophageal varices and collateral veins in patients with liver cirrhosis. 26,31,32 In many scoring systems, the predictive value of Lok index is better than other scoring systems, but because of its low AUROC value, it cannot replace the gold standard endoscopy, so we need to further expand the sample size to verify it. At same time, we will validate the conclusion with more sample number in further research due to the low number of sample in this study.…”

Section: Ta B L E 7 Multivariate Ordered Logistic Regression Analysismentioning

confidence: 99%

The value of platelet parameters and related scoring system in predicting esophageal varices and collateral veins in patients with liver cirrhosis

Liu

Chen

Jiang

et al. 2021

Clinical Laboratory Analysis

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Development and evaluation of a novel score for prediction of large oesophageal varices in patients with hepatitis c virus-induced liver cirrhosis

Abstract: PAP scores a non-invasive, inexpensive and simple score that could predict the presence of large oesophageal varices reducing the need of endoscopy. The PAP score has a superior AUC score than other scores, suggesting improved clinical value.

Cited by 11 publications

References 27 publications

INR-to-platelet ratio (INPR) as a novel noninvasive index for predicting liver fibrosis in chronic hepatitis B

INR-to-platelet ratio (INPR) as a novel noninvasive index for predicting liver fibrosis in chronic hepatitis B

Accuracy of noninvasive tests in the prediction of portal hypertensive gastropathy in Egyptian patients with cirrhosis

The value of platelet parameters and related scoring system in predicting esophageal varices and collateral veins in patients with liver cirrhosis

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