AIM:To determine if liver stiffness(LS) measurements by means of transient elastography(TE) correlate with the presence of significant esophageal varices(EV) and if they can predict the occurrence of variceal bleeding...AIM:To determine if liver stiffness(LS) measurements by means of transient elastography(TE) correlate with the presence of significant esophageal varices(EV) and if they can predict the occurrence of variceal bleeding.METHODS:We studied 1000 cases of liver cirrhosis divided into 2 groups:patients without EV or with grade 1 varices(647 cases) and patients with significant varices(grade 2 and 3 EV)(353 cases).We divided the group of 540 cases with EV into another 2 subgroups:without variceal hemorrhage(375 patients) and patients with a history of variceal bleeding(165 cases).We compared the LS values between the groups using the unpaired t-test and we established cut-off LS values for the presence of significant EV and for the risk of bleeding by using the ROC curve.RESULTS:The mean LS values in the 647 patients without or with grade 1 EV was statistically significantly lower than in the 353 patients with significant EV(26.29 ± 0.60 kPa vs 45.21 ± 1.07 kPa,P < 0.0001).Using the ROC curve we established a cut-off value of 31 kPa for the presence of EV,with 83% sensitivity(95%CI:79.73%-85.93%) and 62% specificity(95% CI:57.15%-66.81%),with 76.2% positive predictive value(PPV)(95% CI:72.72%-79.43%) and 71.3% negative predictive value(NPV)(95% CI:66.37%-76.05%)(AUROC 0.7807,P < 0.0001).The mean LS values in the group with a history of variceal bleeding(165 patients) was statistically significantly higher than in the group with no bleeding history(375 patients):51.92 ± 1.56 kPa vs 35.20 ± 0.91 kPa,P < 0.0001).For a cut-off value of 50.7 kPa,LS had 53.33% sensitivity(95% CI:45.42%-61.13%) and 82.67% specificity(95% CI:78.45%-86.36%),with 82.71% PPV(95% CI:78.5%-86.4%) and 53.66% NPV(95% CI:45.72%-61.47%)(AUROC 0.7300,P < 0.0001) for the prediction of esophageal bleeding.展开更多
文摘AIM:To determine if liver stiffness(LS) measurements by means of transient elastography(TE) correlate with the presence of significant esophageal varices(EV) and if they can predict the occurrence of variceal bleeding.METHODS:We studied 1000 cases of liver cirrhosis divided into 2 groups:patients without EV or with grade 1 varices(647 cases) and patients with significant varices(grade 2 and 3 EV)(353 cases).We divided the group of 540 cases with EV into another 2 subgroups:without variceal hemorrhage(375 patients) and patients with a history of variceal bleeding(165 cases).We compared the LS values between the groups using the unpaired t-test and we established cut-off LS values for the presence of significant EV and for the risk of bleeding by using the ROC curve.RESULTS:The mean LS values in the 647 patients without or with grade 1 EV was statistically significantly lower than in the 353 patients with significant EV(26.29 ± 0.60 kPa vs 45.21 ± 1.07 kPa,P < 0.0001).Using the ROC curve we established a cut-off value of 31 kPa for the presence of EV,with 83% sensitivity(95%CI:79.73%-85.93%) and 62% specificity(95% CI:57.15%-66.81%),with 76.2% positive predictive value(PPV)(95% CI:72.72%-79.43%) and 71.3% negative predictive value(NPV)(95% CI:66.37%-76.05%)(AUROC 0.7807,P < 0.0001).The mean LS values in the group with a history of variceal bleeding(165 patients) was statistically significantly higher than in the group with no bleeding history(375 patients):51.92 ± 1.56 kPa vs 35.20 ± 0.91 kPa,P < 0.0001).For a cut-off value of 50.7 kPa,LS had 53.33% sensitivity(95% CI:45.42%-61.13%) and 82.67% specificity(95% CI:78.45%-86.36%),with 82.71% PPV(95% CI:78.5%-86.4%) and 53.66% NPV(95% CI:45.72%-61.47%)(AUROC 0.7300,P < 0.0001) for the prediction of esophageal bleeding.
