Prediction of esophageal varices in patients with hepatitis B-associated liver cirrhosis by non-invasive markers

Aims

To assess the non-invasive markers for diagnosing and grading esophageal varices(EV) in hepatitis B-associated liver cirrhosis by non-invasive method.

Methods

A total of 209 treatment-naive patients with hepatitis B-associated liver cirrhosis were included in this study. These patients were divided into no EV, large grade EV and any grade EV groups according to electronic gastroscope (EGD) results. Blood tests, physical examination, and abdominal ultrasound scan (USS) were measured. The non-invasive indexes for predicting esophageal varices were screened, and non conditional logistic regression model was established. Performance was expressed as sensitivity, specificity, positive, and negative predictive values (PPV, NPV), accuracy, and area under the curve (AUC).

Results

In the 209 patients, 155 (74.2%) EV and 106(50.7%) large EV were found. There were significant differences in spleen-length (SL), portal vein diameter (PVD), platelet blood cell (PLT) and white blood cell (WBC) between patients with any grade or large and without EV by univariate analysis. The logistic regression model was Y=-2.083-0.011∗PLT+0.101∗PVD+0.013∗SL with any grade EV, the prediction formula is Y= ​0.427-0.013∗PLT -0.861∗WBC+0.008∗SL with large EV.

Conclusions

Spleen-length, portal vein diameter, platelet and white blood cell can predict esophageal varices and large esophageal varices in hepatitis B-associated liver cirrhosis.