Tag-Adeen Mohammed, Alsenbesy Mohamed, Ghweil Ali Abdelrahman, Abd Elrazek M Ali Hussein, Elgohary Elsayed A, Sallam Mohammad M, Ismael Ali, Nawara Abdallah
aDepartment of Internal Medicine, Qena School of Medicine, South Valley University, Qena bDepartment of Tropical Medicine and Gastroenterology, Qena School of Medicine, South Valley University, Qena cDepartment of Tropical Medicine and Gastroenterology, Aswan School of Medicine, Aswan University, Aswan dDepartment of Internal Medicine, Zagazig School of Medicine, Zagazig University, As-Sharqia, Egypt.
Medicine (Baltimore). 2017 Nov;96(46):e8621. doi: 10.1097/MD.0000000000008621.
Although it is an invasive and unpleasant procedure, esophagogastroduodenoscopy (EGD) is still the gold standard for esophageal varices (EV) detection. The aim of this study was to investigate liver stiffness measurement (LSM) and spleen diameter as simple noninvasive tools for EV prediction in chronic hepatitis C patients (CHC).A total of 123 Egyptian patients with CHC have been included and were classified based on screening EGD result into 2 groups; group A (without EV) and group B (with EV). Group (B) was subclassified according to EV grade into 4 subgroups: (B1, grade I), (B2, grade II), (B3, grade III), and (B4, grade IV). LSM was taken for each patient on the next day by an independent Fibroscan operator and correlated to the EGD result. Demographic, clinical, and biochemical data were recorded and analyzed using advanced data-mining computational technology.Mean LSM was 9.94 ± 6 kPa for group A and 33.32 ± 14 kPa for group B, whereas it was 21.22 ± 3, 25.72 ± 6, 33.82 ± 8, and 46.1 ± 15 kPa for subgroups B1, B2, B3, and B4, respectively. Mean spleen diameter was 11.09 ± 1.7 cm for group A and 16.58 ± 1.6 cm for group B. However, LSM ≥17 kPa was the only independent factor for EV prediction; splenic longitudinal span ≥15 cm was a complementary predictor when LSM was <17 kPa. The overall accuracy was 98.33 ± 3.33, Mikro = 98.26%.LSM ≥17 kPa and spleen diameter ≥15 cm is a simple noninvasive algorithm that could be used for prediction of EV and discrimination among its different grades.
尽管食管胃十二指肠镜检查（EGD）是一种侵入性且令人不适的检查方法，但它仍是检测食管静脉曲张（EV）的金标准。本研究的目的是探讨肝脏硬度测量（LSM）和脾脏直径作为慢性丙型肝炎患者（CHC）预测EV的简单非侵入性工具。共纳入123例埃及CHC患者，并根据筛查EGD结果分为2组；A组（无EV）和B组（有EV）。B组根据EV分级再分为4个亚组：（B1，I级）、（B2，II级）、（B3，III级）和（B4，IV级）。次日由独立的Fibroscan操作人员为每位患者进行LSM测量，并将其与EGD结果进行关联。记录人口统计学、临床和生化数据，并使用先进的数据挖掘计算技术进行分析。A组的平均LSM为9.94±6 kPa，B组为33.32±14 kPa，而B1、B2、B3和B4亚组的平均LSM分别为21.22±3、25.72±6、33.82±8和46.1±15 kPa。A组的平均脾脏直径为11.09±1.7 cm，B组为16.58±1.6 cm。然而，LSM≥17 kPa是预测EV的唯一独立因素；当LSM<17 kPa时，脾脏纵向跨度≥15 cm是一个补充预测指标。总体准确率为98.33±3.33，Mikro = 98.26%。LSM≥17 kPa和脾脏直径≥15 cm是一种简单的非侵入性算法，可用于预测EV及其不同分级之间的鉴别。
