Case Control Study
Copyright ©The Author(s) 2019.
World J Gastroenterol. Sep 21, 2019; 25(35): 5323-5333
Published online Sep 21, 2019. doi: 10.3748/wjg.v25.i35.5323
Table 1 Biochemical characteristics of patients with hepatitis B virus-related liver cirrhosis with and without high-risk varices
VariableWithout high-risk varices (n = 105)With high-risk varices (n = 27)P-value
Age46.32 ± 11.8346.74 ± 11.170.8691
Male88 (83.81)25 (92.59)0.2462
BMI (kg/m2)24.6 ± 3.5323.8 ± 2.960.9121
HBeAg: Positive59 (56.19)11 (40.74)0.1512
HBV DNA (log 10, copies/mL)6.27 ± 1.435.08 ± 1.460.0021
Na+ (mmol/L)137.56 ± 13.80139.12 ± 3.070.5601
ALT (U/L)177.0 (64.0-318.0)54.0 (33.0-92.0)0.0003
AST (U/L)144.0 (55.5-266.5)60.0 (37.0-136.9)0.0013
GGT (U/L)105.0 (68.4-198.0)60.0 (35.0-93.0)0.0003
TBil (μmol/L)24.4 (16.75-37.5)27.8 (15.5-48.2)0.6763
ALB (g/L)37.35 ± 5.7436.07 ± 5.740.3051
GLB (g/L)31.4 (28.55-35.65)34.6 (28.6-39.1)0.1013
AFP (ng/mL)16.47 (6.66-74.73)13.6 (7.00-30.1)0.4223
BUN (mmol/L)4.64 ± 1.284.71 ± 1.290.8011
Cr (μmol/L)73.0 (62.0-80.5)73.0 (69.0-90.0)0.2773
PT (s)13.0 (11.8-14.4)15.4 (12.5-16.3)0.0023
INR1.08 (0.98-1.17)1.23 (1.04-1.38)0.0033
PTA (%)85.05 ± 21.3374.52 ± 20.250.0221
WBC (109/L)4.21 (3.28-5.34)3.64 (2.68-4.50)0.0523
PLT (109/L)98.35 ± 46.4967.00 ± 28.290.0001
LSM (kPa)28.93 ± 12.4135.42 ± 14.440.0211
Child-Pugh score5.00 (5.00-7.00)6.00 (5.00-7.00)0.5083
MELD8.83 (7.50-11.76)11.33 (8.81-13.18)0.0253
Data are presented as the mean ± SD, or median (interquartile range).
1t-test results;
2Chi square test results;
3Mann–Whitney U test results.
P < 0.05 was statistically significant. AFP: Alpha-fetoprotein; ALB: Albumin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; BUN: Urea nitrogen; Cr: Creatinine; GGT: Glutamine transpeptidase; GLB: Globulin; HBeAg: Hepatitis B e-antigen; HBV DNA: Hepatitis B virus DNA; INR: International normalized ratio; LSM: Liver stiffness measurement; MELD: Model for End-Stage Liver Disease; Na+: Sodium; PLT: Platelet; PT: Prothrombin time; PTA: Prothrombin activity; TBil: Total bilirubin; WBC: White blood cell.
Table 2 Univariate and multivariate analyses of risk factors associated with high-risk varices in patients who did not meet the 2015 Baveno VI criteria
VariableUnivariate analysis
Multivariate analysis
βOR95%CIP-valueβOR95%CIP-value
PT0.2891.3351.117-1.5950.001
PLT-0.0250.9750.960-0.9900.001
ALT-0.0080.9920.987-0.9970.003-0.0070.9930.987-0.9990.029
GGT-0.0130.9870.979-0.9960.003
LSM0.0351.0351.004-1.0680.0250.0771.0801.030-1.1320.001
MELD0.0911.0961.002-1.1980.045
ALT: Alanine aminotransferase; CI: Confidence interval; GGT: Glutamine transpeptidase; LSM: Liver stiffness measurement; MELD: Model for End-Stage Liver Disease; OR: Odds ratio; PLT: Platelet; PT: Prothrombin time. P < 0.05 was statistically significant.
Table 3 Performance of liver stiffness measurement and serum markers of liver fibrosis in predicting high-risk varices in patients who did not meet the 2015 Baveno VI criteria
VariableAUROC (95%CI)P-valueCutoffvalueSe (%)Sp (%)PPV (%)PLRSpared gastroscopies, n = 132, (%)
LSM0.637 (0.548-0.718)0.014120.910029.5226.71.4231/132 (23.5)
PLT0.712 (0.627-0.787)< 0.0001151.01009.5222.11.1110/132 (7.6)
Lok index0.753 (0.671-0.824)< 0.00010.453110030.4827.01.4432/132 (24.2)
MELD0.644 (0.556-0.726)0.01226.01006.6721.61.077/132 (5.3)
APRI0.586 (0.497-0.671)0.1453
FIB-40.585 (0.496-0.670)0.1281
APRI: Aspartate aminotransferase-to-platelet ratio index; AUROC: Area under the receiver operating characteristic curve; CI: Confidence interval; MELD: Model for End-Stage Liver Disease; PLT: Platelet; PLR: Positive likelihood ratio; PPV: Positive predictive value; Se: Sensitivity; Sp: Specificity. P < 0.05 was statistically significant.
Table 4 Performance of liver stiffness measurement and serum markers of liver fibrosis in predicting high-risk varices in patients with alanine aminotransferase and total bilirubin < 2 upper limit of normal
VariableAUROC (95%CI)P -valueCutoffvalueSe (%)Sp (%)PPV (%)PLRSpared gastroscopies, n = 41, (%)
LSM0.821 (0.670-0.923)< 0.000120.6010066.760.93.0016/41 (39.0)
PLT0.628 (0.464-0.774)0.1928
Lok index0.638 (0.473-0.782)0.1407
MELD0.644 (0.479-0.787)0.1449
APRI0.569 (0.405- 0.722)0.4667
FIB-40.608 (0.444-0.757)0.2474
APRI: Aspartate aminotransferase-to-platelet ratio index; AUROC: Area under the receiver operating characteristic curve; CI: Confidence interval; MELD: Model for End-Stage Liver Disease; PLT: Platelet; PLR: Positive likelihood ratio; PPV: Positive predictive value; Se: Sensitivity; Sp: Specificity. P < 0.05 was statistically significant.
Table 5 Performance of liver stiffness measurement and serum markers of liver fibrosis in predicting high-risk varices in patients with alanine aminotransferase or total bilirubin ≥ 2 upper limit of normal
VariableAUROC (95%CI)P-valueCutoffvalueSe (%)Sp( %)PPV (%)PLRSpared gastroscopies, n = 91, (%)
LSM0.672 (0.565-0.766)0.0508
PLT0.741 (0.639-0.827)< 0.0001100.010051.2825.52.0540/91 (43.9)
Lok index0.814 (0.718-0.888)< 0.00010.559610047.4424.11.9036/91 (39.6)
MELD0.735 (0.632-0.822)0.00037.010012.8216.01.1510/91 (11.0)
APRI0.532 (0.424-0.637)0.7256
FIB-40.576 (0.468-0.679)0.3329
APRI: Aspartate aminotransferase-to-platelet ratio index; AUROC: Area under the receiver operating characteristic curve; CI: Confidence interval; MELD: Model for End-Stage Liver Disease; PLT: Platelet; PLR: Positive likelihood ratio; PPV: Positive predictive value; Se: Sensitivity; Sp: Specificity. P < 0.05 was statistically significant.