Abstract: Objective To analyze the clinical predictive efficacy of the left gastric vein shunt index (LGVSI), spleen stiffness value (SSM), and gamma-glutamyl transpeptidase to platelet ratio (GPR) for the occurrence of high-risk esophageal varices (EGV) in patients with liver cirrhosis (LC). Methods A total of 115 patients with LC combined with EGV who were diagnosed and treated from January 2022 to December 2024 were selected. According to the results of electronic gastroscopy, they were divided into a mild variceal group (n=30), a moderate variceal group (n=48), and a severe variceal group (n=37). Additionally, 68 cases were in the non-EGV group and 47 cases were in the EGV group. The LGVSI, SSM, and GPR scores of each group were detected and compared. Pearson analysis was conducted to explore the correlations between LGVSI, SSM, GPR scores and albumin-bilirubin score (ALBI), FIB-4 index, and Child-Pugh modified grading scores. The receiver operating characteristic curve (ROC) was drawn to analyze the efficacy of combined detection of LGVSI, SSM, and GPR in evaluating EGV. Results The LGVSI, SSM and GPR scores in the severe EGV subgroup were 0.43, 23.29 kPa and 1.28 respectively, which were higher than those of 0.32, 21.06 kPa and 0.69 in the moderate subgroup and 0.21, 17.54 kPa and 0.45 in the mild subgroup, the differences were statistically significant (H=11.439, F=9.185, H=15.627, all P<0.05). The LGVSI, SSM, GPR, ALBI, FIB-4 and Child-Pugh scores in the EGVB subgroup were 0.47, 24.72 kPa, 1.37, -1.15, 5.94 and 2.06 respectively, which were higher than those of 0.28, 19.36 kPa, 0.61, -1.41, 4.51 and 2.43 in the non-EGVB subgroup, and the differences were also statistically significant (Z=7.416, t=7.639, Z=8.264, Z=7.529, t=9.162 and Z=7.284, all P<0.05). Pearson analysis showed that the LGVSI, SSM and GPR scores of patients with HREV in LC were positively correlated with the ALBI, FIB-4 index and Child-Pugh modified grading scores (P<0.01). The ROC curve showed that the AUC, sensitivity and specificity of the combined assessment of LGVSI, SSM and GPR for the occurrence of HREV in LC patients were higher than the efficacy of any single item (P<0.01). Conclusion The combined detection of LGVSI, SSM and GPR score can effectively reflect the degree of liver fibrosis and the bleeding risk of EGV in LC patients, which has high clinical diagnosis efficacy.

Key words: Liver cirrhosis, High-risk esophageal varices, Real-time shear wave elastography, Diagnostic efficacy