Serum fibrosis markers can detect large oesophageal varices with a high accuracy.
OBJECTIVE
The aim of this study was to determine the value of serum fibrosis markers for the diagnosis of oesophageal varices in alcoholic patients.


METHODS
Fifty-four sets of clinical and biochemical data, including serum markers of fibrosis, obtained from 146 heavy alcohol drinkers (106 men, 40 women; mean age 49.2+/-9.0 years) without any history of variceal bleeding were analysed. Gastroscopy and liver biopsy were performed in all patients. Multivariate analysis was performed to identify the markers best correlated with oesophageal varices.


RESULTS
Fifty-nine patients (40.4%) had severe fibrosis (3+) and 48 (32.9%) had oesophageal varices (all grades considered together). In multivariate analysis, a prothrombin index below 60%, alkaline phosphatase activity over 110 IU/l, and hyaluronate over 100 g/l were the best markers for the prediction of oesophageal varices. The diagnostic accuracy for medium to large oesophageal varices using these three factors was 86%. Eight patients (16.7%) with oesophageal varices presented no or moderate fibrosis (F<3): one patient (12.5%) had an alkaline phosphatase level >110 IU/l. However, all eight of these patients had small oesophageal varices.


CONCLUSIONS
These three non-invasive markers correctly predict the presence or absence of medium to large oesophageal varices in 86% of alcoholic patients.
Vanbiervliet
Geoffroy
G
Liver Unit, Archet II Hospital, Nice Cedex 3, France.
Barjoan-Mariné
Eugénia
E
Anty
Rodolphe
R
Piche
Thierry
T
Hastier
Patrick
P
Rakotoarisoa
Christian
C
Benzaken
Sylvia
S
Rampal
Patrick
P
Tran
Albert
A
D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D004812:Epidemiologic Methods; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D008099:Liver / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011516:Prothrombin / Q000032:analysis
D015415:Biomarkers; D011516:Prothrombin; D006820:Hyaluronic Acid; D000469:Alkaline Phosphatase