Hepatobiliary Division, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Acta Med Indones. 2024 Jul;56(3):276-281.
Spleen stiffness measurement (SSM) is a recently developed non-invasive method for predicting clinically significant portal hypertension and esophageal varices in compensated advanced liver disease or cirrhosis. This study aims to validate the accuracy of SSM for screening high-risk esophageal varices among cirrhotic patients in Indonesia.
This is a single-center, cross-sectional study. Patients with liver cirrhosis who underwent endoscopy at Cipto Mangunkusumo Hospital, Jakarta were included. Clinical data and data from laboratory tests, endoscopy, liver, and spleen stiffness measurement by transient elastography (TE) were collected. A 100 Hz spleen-dedicated TE probe was used for SSM.
Of 86 patients, 52 had high-risk esophageal varices. The median (IQR) value of SSM were significantly higher in patients with high-risk varices [36.1 kPa (IQR 21.5-59.1) vs. 70.3 kPa (IQR (52.2-86.0); p<0.001). SSM with a low cutoff value of 20 kPa had sensitivity and negative predictive value of 98.1% and 87.5%, respectively. The high cutoff value of 70 kPa had specificity and positive predictive value of 82.4% and 81.3%, respectively.
SSM is useful for screening high-risk esophageal varices. Furthermore, the new dual cutoff value can help rule-in and rule-out high-risk esophageal varices among cirrhotic patients in Indonesia.
脾脏硬度测量（SSM）是一种最近开发的非侵入性方法，用于预测代偿性晚期肝病或肝硬化患者中临床显著的门静脉高压和食管静脉曲张。本研究旨在验证 SSM 在印度尼西亚肝硬化患者中筛查高危食管静脉曲张的准确性。
这是一项单中心、横断面研究。纳入在雅加达 Cipto Mangunkusumo 医院接受内镜检查的肝硬化患者。收集临床数据和实验室检查、内镜、肝脏和瞬时弹性成像（TE）测量的脾脏硬度数据。使用 100 Hz 脾脏专用 TE 探头进行 SSM。
86 例患者中，52 例有高危食管静脉曲张。高危静脉曲张患者的 SSM 中位数（IQR）值明显较高[36.1 kPa（IQR 21.5-59.1）比 70.3 kPa（IQR（52.2-86.0）；p<0.001）。SSM 的低截断值为 20 kPa 时，其敏感性和阴性预测值分别为 98.1%和 87.5%。高截断值为 70 kPa 时，特异性和阳性预测值分别为 82.4%和 81.3%。
SSM 可用于筛查高危食管静脉曲张。此外，新的双截断值可帮助在印度尼西亚的肝硬化患者中排除和确诊高危食管静脉曲张。
