Evaluation of non-invasive marker of esophageal varices in cirrhosis of liver

Kumar, Pardeep; Singh, Kuldeep; Joshi, Arun B.; Thakur, Priyanka; Mahto, Subodh Kumar; Kumar, Brijesh; Pasricha, Nitasha; Patra, Biswa Ranjan; Lamba, Brinder Mohan Singh

doi:10.4103/jfmpc.jfmpc_854_19

Cited by 8 publications

(10 citation statements)

References 15 publications

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“…Hence, it is now an integral part of hepatologists and gastroenterologist’s daily practice. Among ultrasonic studied parameters in the current study two well-known predictors of portal hypertension and GOV namely portal vein diameter, spleen length were significantly associated with not only esophageal varices but also with advanced varices with certain cutoffs (Table 3), in agreement with many authors [7,9]. Furthermore, a relatively uncommon parameter; the GBWT was studied and was significantly different with both the presence of GOV and with advanced grades of GOV ( P < 0.001).…”

Section: Discussionsupporting

confidence: 91%

“…However, the application of the screening policy among cirrhotics implies that a number of unnecessary endoscopies are carried out. Furthermore, it is invasive, associated with adverse events, not usually available especially in the remote areas and is not accepted by all patients [7] and that is why attempts to validate noninvasive predictors to detect the presence of varices have been tried [7,9].…”

Section: Discussionmentioning

confidence: 99%

“…Hence, many noninvasive predictors for the presence of GOV were investigated including platelet count, portal vein diameter, splenic diameter, etc. [7,8]. There is recent evidence that noninflammatory gallbladder wall thickening (GBWT) measurement may predict the presence of GOV [9].…”

Section: Introductionmentioning

confidence: 99%

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Does gallbladder wall thickness measurement predict esophageal varices in cirrhotic patients with portal hypertension?

Elkerdawy¹,

Ahmed²,

Zaghloul³

et al. 2021

European Journal of Gastroenterology &Amp; Hepatology

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Background and study aim Endoscopy is the gold standard investigation for diagnosis of gastroesophageal varices (GOVs), yet it is invasive, associated with complications. Many noninvasive parameters were investigated to predict the presence of GOVs. The current study investigated gallbladder wall thickening (GBWT) measurement as a noninvasive predictor of GOVs in posthepatitic cirrhotic patients with portal hypertension. Patients and methods In this cross-sectional study, 105 cirrhotic patients were divided into, group I and II according to the presence or absence of GOVs, respectively. Group I subdivided into, groups A and B according to the grade of GOVs either nonadvanced (grades I and II) or advanced (grades III and IV), respectively. Complete history taking, full clinical examination, full investigations, upper endoscopy and abdominal ultrasonography were performed to examine all patients. Results Both groups were comparable in their baseline characteristics except for AST to Platelet Ratio Index and Fibrosis-4 scores, which were significantly higher in group I. GBWT, portal vein diameter and spleen length were significantly associated not only with GOVs but also with its advanced grades. GBWT at a cutoff level >3.1 mm can predict the presence of GOVs with 54.29% sensitivity, 97.14% specificity, 97.4% positive predictive value (PPV), 51.5% negative predictive value (NPV) and 68.5% accuracy. GBWT can predict advanced grades of GOVs at a cutoff level >3.5 mm, with 45% sensitivity, 90% specificity, 64.3% PPV, 80.4% NPV and 77.1% accuracy. Conclusion GBWT was associated with the presence of GOVs, and with advanced GOVs in posthepatitis cirrhotic patients with portal hypertension.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Does gallbladder wall thickness measurement predict esophageal varices in cirrhotic patients with portal hypertension?

Elkerdawy¹,

Ahmed²,

Zaghloul³

et al. 2021

European Journal of Gastroenterology &Amp; Hepatology

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“…Compared with healthy controls, both the lymphocyte count and lymphocyte/monocyte ratio decreased significantly ( Zhang et al, 2015 ; Zhao et al, 2017 ; Zhang et al, 2020 ), and the neutrophil/lymphocyte ratio was markedly elevated ( Zhao et al, 2017 ; Zhang et al, 2020 ). This may be a consequence of chronic systemic inflammation, immune dysfunction, and T-cell exhaustion due to chronic HBV infection ( Lombardo et al, 1995 ; Ye et al, 2015 ; Kalra et al, 2017 ). Additionally, the poor nutritional status of patients with decompensated cirrhosis may contribute to the decreased lymphocyte count/ratio ( O'Keefe et al, 1980 ; Rocha and Fortes, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

“…Studies have suggested that splenomegaly caused by hepatitic cirrhosis is more severe than splenomegaly caused by alcoholic cirrhosis (Kashani et al, 2015). Furthermore, other factors, including toxic effects on the bone marrow induced by drugs or cirrhosis, and reduced thrombopoietin synthesis, could also lead to a decreased platelet count (Kountouras, 2004;Kumar et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Non-Invasive Prediction Models for Esophageal Varices and Red Signs in Patients With Hepatitis B Virus-Related Liver Cirrhosis

Liang

Liu

et al. 2022

Front. Mol. Biosci.

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Background: Red signs are closely related to esophageal variceal bleeding, and, despite improvements in therapy, the mortality rate remains high. We aimed to identify non-invasive predictors of esophageal varices and red signs in patients with hepatitis B virus-related liver cirrhosis.Methods: This retrospective study included 356 patients with hepatitis B virus-related liver cirrhosis after applying inclusion and exclusion criteria among 661 patients. All patients underwent endoscopy, ultrasonography, laboratory examinations, and computed tomography/magnetic resonance imaging. Univariate and multivariate logistic regression analysis were performed, and prediction models for esophageal varices and red signs were constructed.Results: Multivariate analysis revealed that spleen diameter, splenic vein diameter, and lymphocyte ratio were independent risk factors for esophageal varices and red signs. On this basis, we proposed two models: i) a spleen diameter-splenic vein diameter-lymphocyte ratio-esophageal varices prediction model (SSL-EV model); and ii) a spleen diameter-splenic vein diameter-lymphocyte ratio-red sign prediction model (SSL-RS model). The areas under the receiver operating characteristic curve for the two prediction models were 0.843 and 0.783, respectively. With a cutoff value of 1.55, the first prediction model had 81.3% sensitivity and 76.1% specificity for esophageal varices prediction. With a cutoff value of −0.20, the second prediction model had 72.1% sensitivity and 70.7% specificity for the prediction of red signs.Conclusions: We proposed a new statistical model, the spleen diameter-splenic vein diameter-lymphocyte ratio-red sign prediction model (SSL-RS model), to predict the presence of red signs non-invasively. Combined with the spleen diameter-splenic vein diameter-lymphocyte ratio-esophageal varices prediction model (SSL-EV model), these non-invasive prediction models will be helpful in guiding clinical decision-making and preventing the occurrence of esophageal variceal bleeding.

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Etiological Spectrum of Cirrhosis in India: A Systematic Review and Meta-analysis

Swaroop,

Vaishnav,

Arora

et al. 2024

Journal of Clinical and Experimental Hepatology

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Evaluation of non-invasive marker of esophageal varices in cirrhosis of liver

Cited by 8 publications

References 15 publications

Does gallbladder wall thickness measurement predict esophageal varices in cirrhotic patients with portal hypertension?

Does gallbladder wall thickness measurement predict esophageal varices in cirrhotic patients with portal hypertension?

Non-Invasive Prediction Models for Esophageal Varices and Red Signs in Patients With Hepatitis B Virus-Related Liver Cirrhosis

Etiological Spectrum of Cirrhosis in India: A Systematic Review and Meta-analysis

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