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Evaluation of Non-invasive Fibrosis Markers in Predicting Esophageal Variceal Bleeding

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Background/Aims: Esophageal variceal bleeding (EVB) is an important cause of mortality and morbidity in liver cirrhosis. In thisstudy, we aimed to predict the possibility of EVB in patients with cirrhosis using a non-invasive score. Methods: A total of 359 patients with cirrhosis were divided into two groups based on the presence or absence of EVB. Child-Turcotte-Pugh (CTP) score, a model for end-stage liver disease, aspartate aminotransferase to alanine aminotransferase ratio,aspartate aminotransferase to platelet ratio index (APRI), fibrosis-4-index (FIB-4), aspartate aminotransferase to alanineaminotransferase ratio/platelet ratio index (AARPRI), and S-index were measured for all participants. Receiver operatingcharacteristic curves were obtained for all parameters, and the optimal cut-off value was determined in predicting EVB. Results: In patients with EVB, the number of platelets (PLT) were low (p<0.001) and APRI, AARPRI, FIB-4, and S-index weresignificantly higher than those in patients without EBV. APRI, AARPRI, FIB-4, PLT, and S-index were statistically significantpredictors of EVB (p<0.05). Conclusions: FIB-4 and AARPRI, which are non-invasive markers of fibrosis, can be used to predict EVB. In addition, the 66.5 109/Lcut-off value for PLT is important for EVB.

Abstract

Background/Aims: Esophageal variceal bleeding (EVB) is an important cause of mortality and morbidity in liver cirrhosis. In thisstudy, we aimed to predict the possibility of EVB in patients with cirrhosis using a non-invasive score. Methods: A total of 359 patients with cirrhosis were divided into two groups based on the presence or absence of EVB. Child-Turcotte-Pugh (CTP) score, a model for end-stage liver disease, aspartate aminotransferase to alanine aminotransferase ratio,aspartate aminotransferase to platelet ratio index (APRI), fibrosis-4-index (FIB-4), aspartate aminotransferase to alanineaminotransferase ratio/platelet ratio index (AARPRI), and S-index were measured for all participants. Receiver operatingcharacteristic curves were obtained for all parameters, and the optimal cut-off value was determined in predicting EVB. Results: In patients with EVB, the number of platelets (PLT) were low (p<0.001) and APRI, AARPRI, FIB-4, and S-index weresignificantly higher than those in patients without EBV. APRI, AARPRI, FIB-4, PLT, and S-index were statistically significantpredictors of EVB (p<0.05). Conclusions: FIB-4 and AARPRI, which are non-invasive markers of fibrosis, can be used to predict EVB. In addition, the 66.5 109/Lcut-off value for PLT is important for EVB.

참고문헌 (34)

  1. Rahimi RS, "Complications and outcomes in chronic liver disease", Curr Opin Gastroenterol, 27, pp.204~209 (2011)
  2. Ripoll C, "Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis", Gastroenterology, 133, pp.481~488 (2007)
  3. de Franchis R, "Expanding consensus in portal hypertension:report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension", J Hepatol, 63, pp.743~752 (2015)
  4. Garcia-Tsao G, "Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis", Hepatology, 46, pp.922~938 (2007)
  5. Garcia-Tsao G, "Portal hypertensive bleeding in cirrhosis : risk stratification, diagnosis, and management : 2016 practice guidance by the American Association for the study of liver diseases", Hepatology, 65, pp.310~335 (2017)
  6. Gracia-Sancho J, "Hepatic microcirculation and mechanisms of portal hypertension", Nat Rev Gastroenterol Hepatol, 16, pp.221~234 (2019)
  7. Karagiannakis DS, "Evaluation of portal hypertension in the cirrhotic patient : hepatic vein pressure gradient and beyond", Scand J Gastroenterol, 53, pp.1153~1164 (2018)
  8. Stasi C, "Non-invasive assessment of liver fibrosis : between prediction", prevention of outcomes and cost-effectiveness, 2016, pp.22, 1711~1720
  9. Madhotra R, "Prediction of esophageal varices in patients with cirrhosis", J Clin Gastroenterol, 34, pp.81~85 (2002)
  10. Giannini EG, "Platelet count", spleen diameter ratio for the noninvasive diagnosis of esophageal varices : results of a multicenter, prospective, validation study, 2006, pp.101, 2511~2519
  11. Sebastiani G, "Prediction of oesophageal varices in hepatic cirrhosis by simple serum non-invasive markers : results of a multicenter, large-scale study", J Hepatol, 53, pp.630~638 (2010)
  12. Tafarel JR, "Prediction of esophageal varices in hepatic cirrhosis by noninvasive markers", Eur J Gastroenterol Hepatol, 23, pp.754~758 (2011)
  13. Deng H, "Diagnostic accuracy of APRI, AAR, FIB-4, FI, and king scores for diagnosis of esophageal varices in liver cirrhosis : a retrospective study", Med Sci Monit, 21, pp.3961~3977 (2015)
  14. Hong W-D, "Predictors of esophageal varices in patients with HBV-related cirrhosis : a retrospective study", BMC Gastroenterol, 9, pp.11~ (2009)
  15. Tripathi D, "U. K. guidelines on the management of variceal haemorrhage in cirrhotic patients", Gut, 64, pp.1680~1704 (2015)
  16. Obuchowski NA, "Receiver operating characteristic curves and their use in radiology", Radiology, 229, pp.3~8 (2003)
  17. Procopet B, "New tools for the noninvasive assessment of cirrhosis", Curr Hepatology Rep, 13, pp.14~23 (2014)
  18. Stefanescu H, "Noninvasive assessment of portal hypertension in cirrhosis : liver stiffness and beyond", World J Gastroenterol, 20, pp.16811~16819 (2014)
  19. Wang X, "A clinical prediction model and its application for bleeding in chronic liver failure patients with esophageal varices", Eur Rev Med Pharmacol Sci, 17, pp.3046~3055 (2013)
  20. Hanafy AS, "A novel scoring system for prediction of esophageal varices in critically ill patients", Clin Exp Gastroenterol, 10, pp.315~325 (2017)
  21. Wang X-K, "A study on two kinds of scoring models in predicting the degree of esophageal varices and bleeding", Eur Rev Med Pharmacol Sci, 24, pp.3876~3881 (2020)
  22. Iwata Y, "Elevation of the AST to ALT ratio in association with the severity of esophageal varices in patients with HCV-related compensated liver cirrhosis", Hepatogastroenterology, 60, pp.149~152 (2013)
  23. Zhang F, "Predictive value of a noninvasive serological hepatic fibrosis scoring system in cirrhosis combined with oesophageal varices", Can J Gastroenterol Hepatol, 2018, pp.7671508~ (2018)
  24. Shin WG, "Aspartate aminotransferase to platelet ratio index(APRI)can predict liver fibrosis in chronic hepatitis B", Dig Liver Dis, 40, pp.267~274 (2008)
  25. Vallet-Pichard A, "FIB-4 : a simple, inexpensive and accurate marker of fibrosis in HCV-infected patients", Hepatology, 44, pp.769~ (2006)
  26. Vanbiervliet G, "Predictive factors of bleeding related to post-banding ulcer following endoscopic variceal ligation in cirrhotic patients : a case-control study", Aliment Pharmacol Ther, 32, pp.225~232 (2010)
  27. Kothari HG, "Role of non-invasive markers in prediction of esophageal varices and variceal bleeding in patients of alcoholic liver cirrhosis from central India", Turk J Gastroenterol, 30, pp.1036~1043 (2019)
  28. Deng H, "Diagnostic accuracy of APRI, AAR, FIB-4, FI, king, lok, forns, and fibroindex scores in predicting the presence of esophageal varices in liver cirrhosis: a systematic review and meta-analysis", Medicine (Baltimore), 94, pp.e1795~ (2015)
  29. Kraja B, "Predictors of esophageal varices and first variceal bleeding in liver cirrhosis patients", World J Gastroenterol, 23, pp.4806~4814 (2017)
  30. Cardenas A, "Report of the Baveno VI consensus workshop", Ann Hepatol, 15, pp.289~290 (2016)
  31. Sarangapani A, "Noninvasive prediction of large esophageal varices in chronic liver disease patients", Saudi J Gastroenterol, 16, pp.38~42 (2010)
  32. Madonia S, "Prognostic indicators of successful endoscopic sclerotherapy for prevention of rebleeding from oesophageal varices in cirrhosis : a long-term cohort study", Dig Liver Dis, 32, pp.782~791 (2000)
  33. Wang H-W, "New noninvasive index for predicting liver fibrosis in Asian patients with chronic viral hepatitis", Sci Rep, 7, pp.3259~ (2017)
  34. PK MM, "Investigating the efficiency of APRI, FIB-4, AAR and AARPRI as noninvasive markers for predicting hepatic fibrosis in chronic hepatitis B patients in Bangladesh", The Open Microbiology Journal, 13, pp.34~40 (2019)

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