Use of Elastometry for Non-Invasive Screening and Staging of Esophageal Varices in Patients with Hepatitis C Virus -Related Liver Cirrhosis
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Aim: To evaluate liver stiffness measurement as a non-invasive predictor of presence and grade of esophageal varices (EV) in patients with hepatitis C virus infection(HCV)- related liver cirrhosis. Methods: This is a prospective, single-center study that lasted 4 and a half years including all patients with HCV-related liver cirrhosis, compensated or not, and treated at Hassan II University Hospital in Fez, Morocco. Upper endoscopy associated with liver stiffness measurement by FibroScan® are performed by different operators. Results: Forty-six patients were included in the study; the average age was 60.30 +/- 9.9 years with 52.2% of men. Cirrhosis was compensated in 84.8% of cases. Twenty-nine patients (63.0%) had EV (30.4% grade I, 26.1% grade II and 6.5% grade III). 67.4% of patients had large varices. The average of liver stiffness was 21.9 +/-18.7 kPa. The AUROC for the diagnosis of EV was 0.92 and the cut-off value was 13.75 kPa, with a sensitivity of 89.7% and a specificity of 82.4%, positive predictive value (PPV) of 89.66% and a negative predictive value (NPV) of 82.35%. The cut-off for prediction of large varices was 14, 45 Kpa with a sensitivity of 80%, a specificity of 61.3%, a PPV of 50%, an NPV of 86.4% and an AUROC = 0.782. Biological scores AAR, APRI and Fib-4 were also predictors of the presence of EV (Cut-offs respectively 0.95 ≥ - ≥1.59 - ≥3.72 and AUROC of 0.76 - 0.68 - 0.71 respectively) and even the presence of large EV (cut-off respectively of ≥1.15 - ≥1.67 - ≥5.39 and AUROCs respectively of 0.840 – 0.794 – 0.886). Conclusion: Our study proves that liver stiffness measurement can predict the presence and grade of EV in patients with HCV-related liver cirrhosis. The applies to the biological scores AAR, APRI and Fib-4.
Authors and Affiliations
M. Azouaoui, H. El Boujnani, M. El Yousfi, I. Mellouki, D. Benajah, A. Ibrahimi, N. Aqodad
Keywords
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- EP ID EP574541
- DOI 10.9790/0853-1804134553.
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