Grace Lai-Hung Wong1,2,3, Raymond Kwok1,4, Henry Lik-Yuen Chan1,2,3, Stephen Pui-Kit Tang2, Eugenia Lee2, Thomas Chi-Ho Lam2, Tiffany Wing-Yan Lau2, Teresa Man-Kee Ma2, Betsy Chi-Kuen Wong2, Vincent Wai-Sun Wong5,6,7. 1. Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong SAR, China. 2. Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China. 3. State Key Laboratory of Digestive Disease, Chinese University of Hong Kong, Hong Kong SAR, China. 4. Department of Gastroenterology and Hepatology, Concord Repatriation Hospital, Sydney, Australia. 5. Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong SAR, China. wongv@cuhk.edu.hk. 6. Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China. wongv@cuhk.edu.hk. 7. State Key Laboratory of Digestive Disease, Chinese University of Hong Kong, Hong Kong SAR, China. wongv@cuhk.edu.hk.
Abstract
OBJECTIVES: we aimed to investigate the accuracy of liver (LSM) spleen stiffness measurement (SSM) with transient elastography (TE) to predict varices in the presence of non-selective beta-blockers (NSBB). METHODS: In this cross-sectional study of consecutive patients with chronic hepatitis B (CHB) and cirrhosis, all patients underwent TE and upper endoscopic examinations. LSM and SSM in predicting varices in patients receiving and not receiving NSBB were evaluated. RESULTS: Altogether 144 CHB patients (29 receiving NSBB; 35 with any varices, 31 and 11 with esophageal and gastric varices, respectively) were recruited. Their mean LSM and SSM were 13.3 ± 9.0 kPa and 32.8 ± 19.2 kPa, respectively. The correlation between LSM and SSM was better in the NSBB subgroup (r = 0.525, P = 0.003) than its counterpart (r = 0.329, P < 0.001). The area under receiver operating characteristic curve (AUROC) of LSM and SSM for any varices was 0.675 and 0.685 (P = 0.002 and 0.001), respectively. SSM of 18.9 kPa had a negative predictive value of 92.1% and negative likelihood ratio of 0.27 for ruling out any varices; and SSM of 54.9 kPa had a positive predictive value of 56.5% and a positive likelihood ratio of 4.05 to rule in varices. The AUROC of LSM for varices was 0.742 and 0.549 in patients with or without NSBB, respectively; the corresponding AUROC of SSM was 0.572 and 0.603, respectively. CONCLUSIONS: SSM only has modest accuracy to predict varices independent of NSBB use. An SSM cutoff value of 18.9 kPa may be adopted to achieve a high negative predictive value to rule out varices.
OBJECTIVES: we aimed to investigate the accuracy of liver (LSM) spleen stiffness measurement (SSM) with transient elastography (TE) to predict varices in the presence of non-selective beta-blockers (NSBB). METHODS: In this cross-sectional study of consecutive patients with chronic hepatitis B (CHB) and cirrhosis, all patients underwent TE and upper endoscopic examinations. LSM and SSM in predicting varices in patients receiving and not receiving NSBB were evaluated. RESULTS: Altogether 144 CHB patients (29 receiving NSBB; 35 with any varices, 31 and 11 with esophageal and gastric varices, respectively) were recruited. Their mean LSM and SSM were 13.3 ± 9.0 kPa and 32.8 ± 19.2 kPa, respectively. The correlation between LSM and SSM was better in the NSBB subgroup (r = 0.525, P = 0.003) than its counterpart (r = 0.329, P < 0.001). The area under receiver operating characteristic curve (AUROC) of LSM and SSM for any varices was 0.675 and 0.685 (P = 0.002 and 0.001), respectively. SSM of 18.9 kPa had a negative predictive value of 92.1% and negative likelihood ratio of 0.27 for ruling out any varices; and SSM of 54.9 kPa had a positive predictive value of 56.5% and a positive likelihood ratio of 4.05 to rule in varices. The AUROC of LSM for varices was 0.742 and 0.549 in patients with or without NSBB, respectively; the corresponding AUROC of SSM was 0.572 and 0.603, respectively. CONCLUSIONS: SSM only has modest accuracy to predict varices independent of NSBB use. An SSM cutoff value of 18.9 kPa may be adopted to achieve a high negative predictive value to rule out varices.
Authors: Jonathan Chung-Fai Leung; Thomson Chi-Wang Loong; James Pang; Jeremy Lok Wei; Vincent Wai-Sun Wong Journal: Hepatol Int Date: 2017-03-30 Impact factor: 6.047
Authors: Carmen Fierbinteanu-Braticevici; Laura Tribus; Razvan Peagu; Ana Petrisor; Cristian Baicus; Dragos Cretoiu; Artur Pasternak; Gabriela Oprea; Adina Purcareanu; Alexandru C Moldoveanu Journal: Sci Rep Date: 2019-11-07 Impact factor: 4.379