Efficacy of transient elastography in screening for large esophageal varices in patients with suspicious or proven liver cirrhosis.
OBJECTIVE
To evaluate the liver stiffness measurement (LSM) using transient elastography (TE) to predict the risk of esophageal varices (EVs) in Chinese patients.


METHODS
In total, 46 patients with suspicious or proven liver cirrhosis underwent TE and liver biopsy. All participants were endoscopically screened for the presence of EVs and large EVs by two endoscopists who were blinded to the LSM status. Large EVs were defined as more than 5 mm in diameter. Receiver operating characteristic (ROC) curves for both TE and the platelet count/spleen diameter (PC/SD) ratio in predicting the presence of EVs or large EVs were calculated.


RESULTS
Of the 46 patients, 30 (65%) had EVs including 19 (41%) with large EVs. The area under the ROC curve (AUROC) of LSM was 0.85 for the presence of EVs and 0.83 for large EVs, respectively. The cut-off values of LSM were ≥13.4 kPa for the presence of EVs and ≥14.6 kPa for large EVs. Notably, the AUROC of the PC/SD ratio was 0.92 for the presence of EVs but only 0.69 for large EVs.


CONCLUSIONS
LSM using TE can predict the presence of EVs or large EVs in Chinese patients with suspicious or proven cirrhosis and may identify patients who require endoscopic surveillance.
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan, China.
Huay-Min
HM
Wang
Gin-Ho
GH
Lo
Wen-Chi
WC
Chen
Ping-I
PI
Hsu
Hsien-Chung
HC
Yu
Chiun-Ku
CK
Lin
Hoi-Hung
HH
Chan
Wei-Lun
WL
Tsai
Feng-Woei
FW
Tsay
Tsan-Ping
TP
Liu
E-Ming
EM
Wang
Kwok-Hung
KH
Lai
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D019540:Area Under Curve; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010976:Platelet Count; D011237:Predictive Value of Tests; D012372:ROC Curve; D012016:Reference Values; D018570:Risk Assessment; D013154:Spleen / Q000473:pathology*
D000410:Alanine Transaminase