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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 11
Nov.  2018
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Value of liver stiffness-spleen diameter-to-platelet ratio score in predicting esophageal varices in patients with liver cirrhosis

DOI: 10.3969/j.issn.1001-5256.2018.11.014
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  • Published Date: 2018-11-20
  • Objective To investigate the value of liver stiffness-spleen diameter-to-platelet ratio score ( LSPS) in predicting esophageal varices ( EV) in patients with liver cirrhosis. Methods A total of 76 patients with liver cirrhosis who visited The Second Central Hospital of Baoding from October 2012 to August 2017 were enrolled and divided into EV group with 32 patients and non-EV group with 44 patients.Blood samples were collected from all patients for liver function test, routine blood test, and coagulation test. Gastroscopy was performed to evaluate the presence or absence of EV and the degree of EV. Liver stiffness was measured, and aspartate aminotransferase-to-platelet ratio index, fibrosis-4, and LSPS were calculated. The Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. The Spearman correlation analysis was also performed. The receiver operating characteristic ( ROC) curve was plotted to select LSPS corresponding to the maximum sum of sensitivity and specificity as the optimal cut-off value. Results Compared with the non-EV group, the EV group had a significantly lower platelet count ( Z =-6. 932, P < 0. 01) and significantly higher spleen diameter, liver stiffness, and LSPS ( Z =-4. 566, -6. 575, and-7. 323, all P < 0. 01) .Spleen diameter, liver stiffness, and LSPS were positively correlated with EV ( rs= 0. 537, 0. 759, and 0. 775, all P < 0. 001) . The patients with moderate EV had a significantly higher LSPS than those with mild EV [6. 50 ( 5. 71-9. 20) vs 4. 63 ( 2. 12-6. 13) , Z =-2. 010, P = 0. 044]. At the optimal cut-off value of 1. 59, LSPS had a sensitivity of 100%, a specificity of 93. 2%, a positive predictive value of91. 4%, and a negative predictive value of 100% in the diagnosis of EV, with an accuracy of 96. 1%, a Youden index of 93. 2%, and an area under the ROC curve of 0. 994 ( 95% confidence interval: 0. 985-1. 004) , suggesting that LSPS > 1. 59 showed the possibility of EV in cirrhotic patients and gastroscopy was unnecessary for patients with LSPS < 1. 59. Conclusion LSPS has a certain value in predicting the presence or absence of EV in patients with liver cirrhosis.

     

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