Application of noninvasive liver fibrosis score in predicting the severity of esophageal and gastric varices in patients with cirrhosis

Abstract

Abstract: Objective Esophageal variceal bleeding is a complication in patients with portal . The aim of the study was to investigate the clinical value of noninvasive model in predicting the severity of esophageal and gastric varices in patients with cirrhosis. Methods The clinical data of 86 patients admitted to our hospital from May 2020 to January 2021 were collected, including laboratory examination, imaging and gastroscopy results. The severity of esophageal varices was evaluated according to gastroscopy. The predictive value of noninvasive liver fiber scores including aspartate aminotransferase/platelet ratio index (APRI), r-gamma-glutamyl transpeptidase-to-platelet ratio (GPR), fibrosis index based on the four factors (FIB-4), S-index, aspartate transaminase-to-alanine transaminase ratio (AAR) and gamma-glutamyl 1 transpeptitiase-platelet ratio (GAPRI) were compared, and the receiver operator characteristic (ROC) curve conducted. Results The area under the ROC curve of APRI, GPR, FIB-4, S-index, AAR, GAPRI were 0.646, 0.637, 0.634, 0.632, 0.566, 0.636 respectively, and the diagnostic value of APRI was the highest. The specificity of APRI, GPR, FIB-4, S-index, AAR, GAPRI were 56.72%, 89.47%, 36.84%, 73.68%, 57.89%, 89.47%, the specificity of GPR and APRI was the highest. The sensitivity of APRI, GPR, FIB-4, S-index, AAR, GAPRI were 56.72%, 40.30%, 91.04%, 55.22%, 61.19%, 40.30% respectively, sensitivity of APRI was the highest. Platelets, alanine transaminase (ALT), and RDW in mild esophageal varices group were 114.47 ± 50.715, 34.74 ± 15.818, 16.889 ± 2.2521, respectively, while those in severe esophageal varices group were 95.79 ± 42.272, 42.52 ± 24.971, 15.849 ± 2.6023, there was no statistical difference between the two groups (P>0.05). There was no significant difference of APRI, FIB-4, S-index, GAPRI, GPR, and AAR between mild esophageal varices group and severe group [0.637 (0.409, 0.895), 0.637 (0.409, 0.895), 3.562 (2.166, 6.155), 0.435 (0.211, 0.984), and 43.81 (26.829, 64)] vs [901 (0.524,1.407), 0.901 (0.524,1.407), 4.5 (3.335,6.991), 0.891 (0.327,1.778) 61 (29.126144.444), 1.017 (0.485,2.407), 1.48251 ± 0.720318], (P>0.05). Conclusion APRI, GPR, GAPRI and S-index may have a certain predictive value for the severity of esophageal variceal hemorrhage in patients with liver cirrhosis, and the predictive value APRI maybe higher.

Key words: Liver cirrhosis, Esophageal and gastric variceal bleeding, Aspartate aminotransferase/platelet ratio index, R-gamma-glutamyl transpeptidase-to-platelet ratio, Fibrosis index based on the four factors, S-index, Aspartate transaminase-to-alanine transaminase ratio, Gamma-glutamyl 1 transpeptitiase-platelet ratio, Prediction

LI Wen-ting, DANG Tong, WANG Jing, WANG Hai-ying. Application of noninvasive liver fibrosis score in predicting the severity of esophageal and gastric varices in patients with cirrhosis[J]. Chinese Hepatolgy, 2023, 28(2): 171-174.

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