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Transient elastography and simple blood markers in diagnosis of oesophageal varices for compensated patients with hepatitis B virus-related cirrhosis.
MedLine Citation:
PMID:  22432969     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background and Aim:  Transient elastography (TE) was useful in oesophageal varices (OV) diagnosis for chronic hepatitis C patients. We evaluate usefulness of TE and simple blood markers in OV diagnosis for patients with hepatitis B virus (HBV)-related cirrhosis prospectively. Methods:   Consecutive patients with compensated cirrhosis and positive HBV surface antigen were enrolled prospectively. At enrollment, aspartate aminotransferase (AST) to alanine aminotransferase ratio (AAR), AST to platelet ratio index (APRI) were recorded and TE was performed. Two experienced endoscopists assessed OV independently. High-risk OV was defined as small size with red color sign, medium or large size. The diagnostic performances, optimal cut-offs and their validities of TE, APRI, platelet count (PLT) and AAR in OV diagnosis were assessed. Results:   One hundred and twenty-six patients (male/female: 93/33; mean age: 54.5) with reliable TE results were analyzed. There were good agreements between two endoscopists in assessing presence of OV and high-risk OV (kappa value: 0.82 and 0.96). Forty-eight (38.1%) patients had OV (small: 35; high-risk: 13). There was correlation between TE result and OV size (r=0.515, p<0.001). TE, APRI and PLT were similar however, superior to AAR, in diagnostic accuracies for OV and high-risk OV. In high-risk OV prediction, the negative predictive value was 97%, 98% and 98% with the cut-offs of 21 kPa, 1.24 and 110 (x10(9) /L) for TE, APRI and PLT, respectively. Conclusions:   For compensated patients with HBV-related cirrhosis, TE, APRI and PLT are useful in excluding high-risk OV with high negative predictive value. © 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Authors:
Jing-Houng Wang; Seng-Kee Chuah; Sheng-Nan Lu; Chao-Hung Hung; Chien-Hung Chen; Kwong-Ming Kee; Kuo-Chin Chang; Wei-Chen Tai; Tsung-Hui Hu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-20
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  -     ISSN:  1440-1746     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Affiliation:
Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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