Correlation between esophageal wall thickness on CT plain scan and red color sign on endoscopy in patients with liver cirrhosis: a cross-sectional study

Abstract

Abstract: Objective To analyze the correlation between esophageal wall thickness(EWT) measured by CT plain scan and the red colour sign(RCS) observed during endoscopy, aiming to predict esophageal variceal bleeding in patients with cirrhosis. Methods A total of 125 patients with hepatitis B cirrhosis who underwent endoscopy and CT plain scans at Xingtai People's Hospital from January 2019 to May 2022 were enrolled in this study. The subjects were divided into two groups based on the presence or absence of the RCS: the RCS-positive group and the RCS-negative group. The clinical characteristics of patients in both groups were compared.Logistic regression analysis was performed to identify variables related to RCS.The diagnostic efficacy of EWT was assessed using the receiver operating characteristic (ROC) curve, and the Youden index was utilized to determine the cut-off value. Results The stufy included 125 patients, consisting of 86 males and 39 females, with a mean age of 53.6±11.7 years. Among them, 84 patients did not present with the RCS, while 41 did. The platelet and serum albumin values in patients with RCS were 75(45.75-93.5)×10⁹/L, and 34.45±4.49 g/L, respectively, which were significantly lower than those in patients without RCS, 97(73-148)×10⁹/L and 37.44±6.25 g/L, (P<0.05). Prothrombin time, international normalized ratio and Child-Pugh score in the RCS-positive group were 14.0(12.5-16.6)s, 1.28(1.15-1.46), and 8(7-9), respectively, which were significantly higher than those in the RCS-negative group,12.5 (11.4,15.1) s, 1.15 (1.04,1.31), and 7 (6,8)(P<0.05). The incidence of ascites was also higher in the RCS-postive group (25 (29.7%) vs20 (48.8%)). EWT was significantly higher in patients with RCS(Z=-6.663,P=0.000). Multivariate regression analysis identified EWT as an independent risk factor for RCS(HR=1.405; 95%CI:1.203-1.64,P=0.000).The area under the curve (AUC) for diagnosing RCs based on EWT was 0.868 (95%CI:0.804-0.931,P=0.000), with a cut off value of 7.14 mm. Conclusion EWT can be used as a screening index for RCS and provide a stratified index for clinical screening of esophageal varices bleeding.

Key words: Red color sign, Endoscopy, Liver cirrhosis, Esophageal wall thickness

WANG Xiao-juan, WANG Ji-tao, LI Jin-long, WANG Wen-chuan, MENG Ling-lei, MIAO Jie, GAO Feng-xiao. Correlation between esophageal wall thickness on CT plain scan and red color sign on endoscopy in patients with liver cirrhosis: a cross-sectional study[J]. Chinese Hepatolgy, 2024, 29(6): 691-694.

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