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©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2019; 25(35): 5323-5333
Published online Sep 21, 2019. doi: 10.3748/wjg.v25.i35.5323
Published online Sep 21, 2019. doi: 10.3748/wjg.v25.i35.5323
Liver stiffness and serum markers for excluding high-risk varices in patients who do not meet Baveno VI criteria
Hong Zhou, Jun Long, Han Hu, Cai-Yun Tian, Shi-De Lin, Department of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
Hong Zhou, Department of Infectious Diseases, Suining Central Hospital, Suining 629000, Sichuan Province, China
Author contributions: Zhou H and Long J contributed equally to this work; Zhou H, Long J, Hu H, Tian CY, and Lin SD performed the research; Zhou H and Lin SD wrote the manuscript; Long J and Lin SD performed the biostatistics analysis; Hu H, Tian CY, and Lin SD analyzed the data; all authors discussed the results and commented on the manuscript.
Supported by the National Natural Science Foundation of China , No. 81860114 .
Institutional review board statement: This study was approved by the Institutional Review Board of Affiliated Hospital of Zunyi Medical University, Guizhou Province, China.
Informed consent statement: All patients were informed in writing of the use of their data for clinical research purposes and accepted.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest in this study.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Shi-De Lin, MD, Occupational Physician, Professor, Department of Infectious Diseases, Affiliated Hospital of Zunyi Medical University, 201 Dalian Street, Zunyi 563003, Guizhou Province, China. linshide6@zmu.edu.cn
Telephone: +86-851-28609183 Fax: +86-851-28609183
Received: May 29, 2019
Peer-review started: May 30, 2019
First decision: July 21, 2019
Revised: July 30, 2019
Accepted: August 24, 2019
Article in press: July 21, 2019
Published online: September 21, 2019
Peer-review started: May 30, 2019
First decision: July 21, 2019
Revised: July 30, 2019
Accepted: August 24, 2019
Article in press: July 21, 2019
Published online: September 21, 2019
Core Tip
Core tip: In patients with hepatitis B virus (HBV)-related compensated cirrhosis who did not meet the Baveno VI criteria, the prevalence of high-risk varices among patients with alanine transaminase (ALT) or total bilirubin (TBil) ≥ 2 upper limit of normal (ULN) was significantly lower compared to patients with ALT and TBil < 2 ULN. In the 41 patients with ALT and TBil < 2 ULN, liver stiffness measurement (LSM) < 20.6 kPa spared 39.0% of gastroscopies without missing high-risk varices (HRVs). In the 91 patients with ALT or TBiL ≥ 2 ULN, Lok index ≤ 0.5596 or platelet (PLT) > 100 × 109/L further spared 39.6% and 43.9% of gastroscopies, respectively, without missing HRVs.