Tianjin Second People's Hospital, Tianjin Institute of Hepatology, No. 75 Sudi Road, Nankai District, Tianjin, 300192, China.
Department of Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, No.1 Zhongfu Road, Gulou District, Nanjing, 210003, China.
BMC Gastroenterol. 2024 Nov 1;24(1):390. doi: 10.1186/s12876-024-03407-4.
The aim of our study was to evaluate the indocyanine green (ICG) retention test as a noninvasive marker of esophageal varices(EV).
The clinical data of patients diagnosed with compensated liver cirrhosis in Tianjin Second People's Hospital between January 2018 and January 2021 were analysed with SPSS 23.0.
A total of 144 patients (88 M/56 F, 51.7 ± 11.06 years) were enrolled. The ICG retention at 15 min(ICG-r15), PVD, TBIL, Cholinesterase(CHE), AST to ALT ratio(ARR), APRI, splenic area, Lok index, Park index and liver stiffness measurement in the absent or small EV group were lower than those in the medium or large EV group, while the ICG disappareance rate(ICG-K), Effective hepatic blood flow(EHBF), ALB, PLT, and Platelet to Spleen Diameter Ratio(PSDR) were higher, and the differences were significant (P < 0.05). ICG-r15, splenic area, APRI and PLT were independent predictors for medium or large esophageal varices (OR = 1.115, 1.025, 0.281, and 0.987, respectively,P < 0.05). The predictive value of ICG-r15 for medium or large varices was 17.95%, the specificity was 0.849, and the sensitivity was 0.662, the AUROC was 0.815. The cut-off value of PLT for M/L EV was 113.5, and the specificity and sensitivity were 0.616 and 0.887, the AUROC was 0.759. The AUROC of ICG-r15 combined with PLT was 0.866, which was more superior than others.
Although we are far from the replacement of endoscopy, ICG-r15 combined with PLT seems to be able to identify patients with medium or large EV in patients with compensated liver cirrhosis.
本研究旨在评估吲哚菁绿（ICG）保留试验作为食管静脉曲张（EV）的无创标志物。
分析 2018 年 1 月至 2021 年 1 月期间在天津市第二人民医院诊断为代偿性肝硬化的患者的临床数据。
共纳入 144 例患者（88 例男性/56 例女性，51.7±11.06 岁）。在无或小 EV 组中，ICG 保留 15 分钟（ICG-r15）、PVD、TBIL、胆碱酯酶（CHE）、AST 与 ALT 比值（ARR）、APRI、脾脏面积、Lok 指数、Park 指数和肝硬度测量值均低于中或大 EV 组，而 ICG 消失率（ICG-K）、有效肝血流量（EHBF）、ALB、PLT 和血小板与脾脏直径比（PSDR）较高，差异有统计学意义（P<0.05）。ICG-r15、脾脏面积、APRI 和 PLT 是中或大食管静脉曲张的独立预测因子（OR=1.115、1.025、0.281 和 0.987，P<0.05）。ICG-r15 对中或大血管病变的预测价值为 17.95%，特异性为 0.849，敏感性为 0.662，AUROC 为 0.815。PLT 对 M/L EV 的截断值为 113.5，特异性和敏感性分别为 0.616 和 0.887，AUROC 为 0.759。ICG-r15 联合 PLT 的 AUROC 为 0.866，优于其他方法。
虽然我们远未达到内镜检查的替代水平，但 ICG-r15 联合 PLT 似乎能够识别代偿性肝硬化患者中的中或大 EV 患者。
