Abstract: Objective To investigate the influence of paltelet (PLT), hyaluronic acid (HA), laminin (LN), type III procollagen N-terminal peptide (PIIINP), type IV collagen (CIV), spleen diameter (SD), liver hardness (LSM) and LSP score obtained by combining LSM, SD and PLT on esophageal varices (EV) in patients with hepatitis B virus (HBV) related cirrhosis.Methods The data of 162 patients with HBV related cirrhosis admitted to our hospital from January 2019 to March 2022 were reviewed, including 105 males and 57 females, aged 54 (40, 76) years. HBV related cirrhosis meets the diagnostic requirements. According to gastroscopy, patients withe EV were divided into different groups.Results Among the 62 patients with HBV related cirrhosis, 27 cases without EV, 59 cases with mild to moderate EV and 76 cases with severe EV, respectively. The PLT of no-EV group, mild to moderate EV group and severe EV group were 122 (76, 140) × 10⁹/L, 76 (56, 102) × 10⁹/L and 58 (44, 81) × 10⁹/L, the difference was statistically significant (P<0.05). HA, LN, PIIINP and CIV in the EV group were 258.2 (105.6, 580.5) μg/mL, 107.5 (60.7, 142.9) μg/mL, 14.0 (6.8, 17.2) μg/mL and 128.0 (63.2, 264) μg/mL, compared with mild to moderate EV group [352.4 (167.0, 627.8) μg/mL, 140.2 (69.8, 188.5) μg/mL, 16.2 (7.3, 33.5) μg/mL and 153.2 (84.8, 229.9) μg/mL, severe EV group [640.2 (290.2, 918.7) μg/mL, 158.7 (94.6, 236.4) μg/mL, 19.6 (9.5, 47.5) μg/mL and 180.7 (119.0, 282.6) μg/mL], the differences were statistically significant (P<0.05). SD of no EV group, mild to moderate EV group and severe EV group were 13.2 (10.8, 15.0) cm, 14.4 (11.4, 16.0) cm and 15.8 (14.6, 17.2) cm, the difference was statistically significant (P<0.05). The scores of LSM and LSP in EV group were 14.8 (10.6, 24.0) kPa and 1.9 (1.0, 3.5) points, compared with mild to moderate EV group [24.7 (17.8, 29.5) kPa and 4.6 (2.4, 7.2) points] and severe EV group [37.2 (28.8, 42.6) kPa and 10.0 (6.2, 14.2) points], respectively, the differences were statistically significant (P<0.05). The correlation between the above indexes of liver fibrosis and EV degree was analyzed. The results showed that SD, LSM and LSPS were moderately positively correlated with EV degree (r=0.51, 0.63 and 0.67, P<0.05), while HA, LN, PIIINP and CIV were weakly positively correlated with EV degree (r=0.25, 0.28, 0.21 and 0.23, P<0.05), however, PLT was negatively correlated with EV (r=-0.41, P<0.05). Evaluation of diagnostic efficacy of various indexes of liver fibrosis for EV showed that the diagnostic AUC values of PLT, HA, LN, PIIINP, CIV, SD, LSM and LSP scores were 0.77, 0.65, 0.64, 0.61, 0.59, 0.77, 0.84 and 0.87, respectively. Evaluate the diagnostic efficacy of various liver fibrosis indexes for severe EV. As shown in Table 3, the diagnostic AUC values of PLT, HA, LN, PIIINP, CIV, SD, LSM and LSP scores are 0.71, 0.64, 0.59, 0.62, 0.60, 0.77, 0.84 and 0.86, respectively.Conclusion PLT, HA, LN, PIIINP, CIV, SD, LSM and LSP scores were correlated with EV status in patients with HBV related cirrhosis, among which LSP score had better diagnostic efficacy for the presence of EV and severe EV, and had guiding significance for the treatment of patients with HBV related cirrhosis.

Key words: Chronic hepatitis B, Cirrhosis, Esophageal varices, Liver stiffness measurement, Spleen diameter