Noninvasive index for diagnosing the degree of esophageal varices in patients with hepatitis B virus-related cirrhosis

Abstract

Objective To assess the noninvasive index for diagnosing the degree of esophageal varices (EV) in patients with hepatitis B virus (HBV) -related cirrhosis. Methods The clinical data of 112 patients with HBV-related cirrhosis were studied retrospectively. The patients were divided into non-EV (NEV) group (30 cases) and EV group (82 cases) according to the results of gastroscopy. In EV group, there were mild varices in 21 cases (mild EV group), moderate varices in 47 cases (moderate EV group) and severe varices in 14 cases (severe EV group). The age, gender, platelets, glutamyl transpeptidase, prothrombin time, albumin, bilirubin, portal vein diameter, spleen vein diameter and thickness of spleen were compared, and the relationship was analyzed between each index and EV. Results There were no statistical differences in gender, age, albumin, bilirubin, prothrombin time and glutamyl transpeptidase between NEV group and EV group (P >0.05). The portal vein diameter, spleen vein diameter and thickness of spleen in EV group were significantly higher than those in NEV group: (14.1 ± 3.1) mm vs. (10.6 ± 2.3) mm, (8.9 ± 2.1) mm vs. (7.6 ± 1.6) mm and (4.8 ± 0.9) mm vs. (3.8 ± 1.0) mm, the platelets in EV group was significantly lower than that in NEV group: (86.8 ± 20.2) × 109/L vs. (163.5 ± 18.1) × 109/L, and there were statistical differences (P <0.01 or <0.05). The portal vein diameter, spleen vein diameter and thickness of spleen in moderate EV group and severe EV group were significantly higher than those that in NEV group and mild EV group: (13.5 ± 2.1) and (14.8 ± 3.6) mm vs. (10.6 ± 2.3) and (11.2 ± 3.1) mm, (8.3 ± 2.1) and (9.1 ± 1.1) mm vs. (7.6 ± 1.6) and (8.1 ± 1.9) mm, (4.7 ± 1.1) and (4.9 ± 0.9) mm vs. (3.8 ± 1.0) and (4.1 ± 1.2) mm, the platelet levels were significantly lower than those in NEV group and mild EV group: (72.8 ± 11.6) × 109/L and (63.8 ± 15.6) × 109/L vs. (163.5 ± 18.1) × 109/L and (100.2 ± 10.3) × 109/L, and there were statistical differences (P<0.05). The area under curve of response operating characteristic for predicting the presence of moderate and severe EV with portal vein diameter and platelets were 0.719 and 0.735, and the cut off value were 14 mm and 69 × 109/L. Conclusions The portal vein diameter and platelets can predict the presence of moderate and severe EV in patients with HBV-related cirrhosis. Key words: Liver Cirrhosis; Hepatitis B; Esophageal and gastric varices