title: Liver stiffness measurement by fibroscan predicts the presence and size of esophageal varices in egyptian patients with HCV related liver cirrhosis.
abstract: OBJECTIVE
  Liver stiffness measured by transient elastgraphy correlates with Hepatic vein pressure gradient, liver Stiffness value of 21 kpa predicts significant portal hypertension. Aim is to predict esophageal varices presence by fibroscan and possible grading by degree of liver stiffness in HCV related cirrhotic patients.
  
  
  METHODS
  Thirty two HCV related cirrhotic patients were recruited, age > 18 years, BMI< 35, no history of: upper GI bleeding, hepatocellular carcinoma, abdominal collaterals, ascites. Patients underwent clinical examination, laboratory investigations, abdominal ultrasonography, upper endoscopy and fibroscan. They divided into (Group I= no varices, Group II =small varices (Grade 1 & 2), Group III = large varices (Grade 3 & 4).
  
  
  RESULTS
  Age is higher in Group III than I & II (55+6.6 vs 49.5+4.7 & 48.9+4.7, p-value 0.04) respectively, Groups were gender & BMI matched, fibroscan values in Group I vs II & III were 27 Vs 49.4, p value 0.01, cutoff 29.7 Kpa (sensitivity 95% & specificity 67%) while its value in Group II vs III were 38.4 vs 60.4, p value 0.002, cutoff 38.2 Kpa (sensitivity 100% & specificity77.3%). Platelet count, splenic size, platelet count/splenic size in Group I vs II & III were 107.166 vs 72.900, 13.8 vs 15.4, 803.6 vs 478, p value 0.01, 0.008, 0.005, cutoff 80.000, 14.5, 545, sensitivity & specificity (85%&75%, 75%&75%, 85%&84%) respectively. On multivariate analysis fibroscan (OR 1.113; p=0.005) & platelet count/splenic size (OR 0.995; p=0.012) were positive predictors of esophageal varices presence.
  
  
  CONCLUSIONS
  Fibroscan is a good non-invasive method to predict esophageal varices presence & possible grading with high sensitivity.
authors.affiliation: Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University , Cairo, Egypt .
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Saad
authors.forename: Mohamed
authors.initials: M
authors.lastname: Said
authors.forename: Mohamed O
authors.initials: MO
authors.lastname: Idris
authors.forename: Ayman
authors.initials: A
authors.lastname: Rabee
authors.forename: Salama
authors.initials: S
authors.lastname: Zakaria
keywords: Esophageal varices; Fibroscan; Grading; Non-invasive methods