Diagnostic accuracy of liver and spleen stiffness measured by fibroscan® in the prediction of esophageal varices in HCV-related cirrhosis patients treated with oral antivirals
| Autor: | Carolina Muñoz-Codoceo, Ana Martin, Gregorio Castellano, Cristina Martín-Arriscado Arroba, Lidia Cuevas del Campo, R. Muñoz, Inmaculada Fernández, Maria Amo, Maria Luisa Manzano |
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| Rok vydání: | 2021 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis Population Administration Oral Diagnostic accuracy Spleen Esophageal and Gastric Varices Gastroenterology Antiviral Agents 03 medical and health sciences 0302 clinical medicine Esophageal varices Predictive Value of Tests Internal medicine medicine Humans Platelet education Aged Splenic Diseases education.field_of_study Hepatology business.industry Liver Diseases Reproducibility of Results Hepatitis C Chronic Middle Aged medicine.disease Gastroesophageal varices medicine.anatomical_structure Cross-Sectional Studies 030220 oncology & carcinogenesis Elasticity Imaging Techniques 030211 gastroenterology & hepatology Female business Transient elastography |
| Zdroj: | Gastroenterología y Hepatología (English Edition). 44:269-276 |
| ISSN: | 2444-3824 |
| DOI: | 10.1016/j.gastre.2020.09.003 |
| Popis: | Introduction The aim of this study was to investigate the accuracy of liver and spleen stiffness measurement by transient elastography for the prediction of gastroesophageal varices in patients with HCV-associated cirrhosis treated with new direct-acting antiviral agents. Patients and methods This cross-sectional observational study included patients with compensated HCV-related cirrhosis and sustained virological response after direct-acting antiviral therapy. Patients underwent liver and spleen stiffness measurement, abdominal ultrasound and oesophago-gastroduodenoscopy. Clinical and laboratory data and non-invasive markers such as the liver stiffness–spleen diameter to platelet ratio score, variceal risk index and platelet count to spleen diameter ratio were analyzed. Results Ninety-seven consecutive patients were included. Liver stiffness measurement (12.2 vs 16; p = 0.02), spleen stiffness measurement (39.4 vs 46.05; p = 0.04), liver stiffness–spleen diameter to platelet ratio score (1.21 vs 2.02; p = 0.008), platelet count to spleen diameter ratio (1102.19 vs 829.7; p = 0.04) and variceal risk index (−3.4 vs −1.02; p = 0.01) showed significant differences between patients without/with gastroesophageal varices. The best cut-off value to discard the presence of gastroesophageal varices was 12.3 kPa for liver stiffness measurement and 27 kPa for spleen stiffness measurement. However, diagnostic accuracy was moderate (AUROC: 0.671 and 0.624 respectively). Combining different non-invasive parameters did not significantly improve the overall performance. Discussion Liver and spleen stiffness measurement showed suboptimal results for non-invasive assessment of gastroesophageal varices in HCV cirrhotic patients treated with direct-acting antiviral agents. Our results suggest that non-invasive methods cannot substitute standard procedures for predicting gastroesophageal varices in this population. |
| Databáze: | OpenAIRE |
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