Noninvasive Fibrosis Scores as Prognostic Markers for Varices Needing Treatment in Advanced Compensated Liver Cirrhosis  

作　　者：Elham Ahmed Hassan Abeer Sharaf El-Din Abd El-Rehim Zain El-Abdeen Ahmed Sayed Ahmed Mohmmed Ashmawy Emad Farah Mohamed Kholef Abeer Sabry Wael Abd-Elgwad Elsewify 

机构地区：[1]Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt [2]Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt [3]Department of Clinical pathology, Faculty of Medicine, Aswan University, Aswan, Egypt [4]Department of Internal Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt [5]Department of Internal Medicine, Faculty of Medicine, Aswan University, Aswan, Egypt

出　　处：《Open Journal of Gastroenterology》2017年第8期230-242,共13页肠胃病学期刊（英文）

摘　　要：Background/purpose: Noninvasive assessment of esophageal varices (EVs), their size and bleeding stigmata may reduce endoscopic burden, cost and drawbacks. We aimed to evaluate the diagnostic performance of noninvasive fibrosis scores (AAR, APRI, FIB-4, King and VITRO scores) in predicting the presence of EVs and high risk varices needing treatment (VNT) in HCV-related cirrhosis of Egyptian patients. Methods: This prospective study included 154 HCV-related advanced compensated cirrhotic patients with no history of bleeding who underwent screening endoscopy for EVs. AAR, APRI, FIB-4, King and VITRO scores were assessed. Results: Esophageal varices were found in 120 patients (77.9%) and VNT in 92 patients (59.7%). Apart from AAR, all scores demonstrated statistically significant correlations with the presence and the size of EVs. Using area under receiver operating characteristic curve (AUC), these scores were good predictors for the presence of EVs and VNT, where VITRO score had the highest AUC (0.920 and 0.900) and accuracy (97.1% and 87%), sensitivity (75, 82.6%), specificity (100, 93.5%), PPV (100, 95%) and NPV (53.2, 78.4%) with cutoffs >1.3 and >1.8 respectively. Conclusion: Noninvasive fibrosis scores can predict the presence of EVs and VNT. VITRO score was the best predictor with higher accuracy for clinical applicability than studied scores.Background/purpose: Noninvasive assessment of esophageal varices (EVs), their size and bleeding stigmata may reduce endoscopic burden, cost and drawbacks. We aimed to evaluate the diagnostic performance of noninvasive fibrosis scores (AAR, APRI, FIB-4, King and VITRO scores) in predicting the presence of EVs and high risk varices needing treatment (VNT) in HCV-related cirrhosis of Egyptian patients. Methods: This prospective study included 154 HCV-related advanced compensated cirrhotic patients with no history of bleeding who underwent screening endoscopy for EVs. AAR, APRI, FIB-4, King and VITRO scores were assessed. Results: Esophageal varices were found in 120 patients (77.9%) and VNT in 92 patients (59.7%). Apart from AAR, all scores demonstrated statistically significant correlations with the presence and the size of EVs. Using area under receiver operating characteristic curve (AUC), these scores were good predictors for the presence of EVs and VNT, where VITRO score had the highest AUC (0.920 and 0.900) and accuracy (97.1% and 87%), sensitivity (75, 82.6%), specificity (100, 93.5%), PPV (100, 95%) and NPV (53.2, 78.4%) with cutoffs >1.3 and >1.8 respectively. Conclusion: Noninvasive fibrosis scores can predict the presence of EVs and VNT. VITRO score was the best predictor with higher accuracy for clinical applicability than studied scores.

关 键 词：ESOPHAGEAL VARICES Hepatitis C Liver Cirrhosis VITRO Score 

分 类 号：R5[医药卫生—内科学]