title: Evaluation the value of markers for prediction of portal vein thrombosis after devascularization.
abstract: OBJECTIVE
  To evaluate the value of D-dimer and P-selectin in cirrhotic portal hypertension (PHT) patients for prediction of portal vein thrombosis (PVT) after devascularization.
  
  
  METHODS
  137 patients with cirrhotic PHT who undergone devascularization from January 2012 to April 2014 were retrospectively reviewed, all of them were divided into two groups (PVT group and non-PVT group) by Doppler ultrasonography (DU) examination. The level of D-dimer and P-selectin was tested during the peri-operative period.
  
  
  RESULTS
  38 patients (27.7%) were found PVT by DU examination post-operatively. In contrast to the non- PVT group, the level of D-dimer and P-selectin in the PVT group was much higher significantly at 1, 3 and 7 days after devascularization (P < 0.05). However, in the 15 days after surgery, the difference of P-selectin between the two groups was not significant (P = 0.260). It was shown that the higher sensitivity of the two markers for PVT was D-dimer, the higher specificity belonged to P-selectin. The area under receiver operating characteristic (ROC) curve of P-selectin was the bigger of the two markers. When the two markers were combined to be used to diagnose PVT, the sensitivity was increased to 0.911, with a slight drop of specificity to 0.715, the area under ROC curve was 0.919.
  
  
  CONCLUSIONS
  The level of D-dimer and P-selectin might be good candidate predictive markers for PVT in patients with cirrhotic PHT after devascularization. The combined test of the two markers can increase the value of prediction.
authors.affiliation: Department of General Surgery, the 81st Hospital of P.L.A. Nanjing, JiangSu, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Fei
authors.affiliation: Department of General Surgery, the 81st Hospital of P.L.A. Nanjing, JiangSu, China.
authors.forename: Guang-quan
authors.initials: GQ
authors.lastname: Zong
authors.affiliation: Department of General Surgery, the 81st Hospital of P.L.A. Nanjing, JiangSu, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of General Surgery, the 81st Hospital of P.L.A. Nanjing, JiangSu, China.
authors.forename: Ren-min
authors.initials: RM
authors.lastname: Liu
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood*; D011169:Portal Vein / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology*
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D019007:P-Selectin; C546937:SELP protein, human; C036309:fibrin fragment D