Non-invasive model for predicting esophageal varices based on liver and spleen volume

Table 1 Comparison of general characteristics of the modeling group, n

Parameter	Patients with EVs, n = 86	Patients without EVs, n = 25	All patients, n = 111	P value
Age, yr	53.55 ± 11.58	51.32 ± 12.03	53.05 ± 11.12	0.28
Male (%)	47 (54.7)	17 (68.0)	64 (55.7)	0.47
Etiology, HBV/HCV	73/13	17/8	90/21	0.51
Child-Pugh class, A/B/C	45/34/7	21/4/0	66/38/7	< 0.01
Red Sign	36	0	36	< 0.01

P < 0.05 is considered statistical significance. EVs: Esophageal varices; HBV: Hepatitis B virus; HCV: Hepatitis C virus.

Table 2 Comparison of general characteristics of the external validation group, n

Parameter	Patients with EVs, n = 37	Patients without EVs, n = 19	All patients, n = 56	P value
Age, yr	51.46 ± 10.87	53.03 ± 11.41	54.68 ± 10.93	0.39
Male (%)	20 (54.1)	10 (52.6)	30 (53.6)	0.43
Etiology, HBV/HCV	27/10	15/4	42/14	0.56
Child-Pugh class, A/B/C	13/21/3	12/7/0	25/28/3	< 0.05
Red sign	14	0	14	< 0.01

P < 0.05 is considered statisticall significance. EVs: Esophageal varices; HBV: Hepatitis B virus; HCV: Hepatitis C virus.

Table 3 Univariate analysis of parameters of patients with esophageal varices and without esophageal varices

Parameter	Patients with EVs, n = 86	Patients without EVs, n = 25	P value
PVSA (mm3)	211.96 ± 69.98	175.16 ± 77.43	0.04
PVD (mm)	13.76 ± 2.48	12.94 ± 2.73	< 0.05
SVD (mm)	9.54 ± 3.21	7.16 ± 3.36	< 0.01
CTLV (cm3)	913.54 ± 312.89	1241.92 ± 34.83	< 0.01
CTSV (cm3)	787.78 ± 399.46	439.23 ± 126.25	< 0.01
SSV (cm3)	176.44 ± 31.21	195.71 ± 33.88	0.10
SLV (cm3)	1049.40 ± 188.53	1136.97 ± 174.13	0.10
Rate of liver volume change	-0.12 ± 0.55	0.12 ± 0.48	< 0.01
Rate of spleen volume change	3.46 ± 2.49	1.38 ± 2.73	< 0.01
Liver volume change (cm3)	135.85 ± 334.26	112.05 ± 280.68	0.01
Spleen volume change (cm3)	243.52 ± 163.89	611.33 ± 293.17	< 0.01
ALT (IU/L)	32.08 ± 5.44	49.44 ± 7.63	0.16
AST (IU/L)	45.05 ± 7.98	65.28 ± 8.14	0.26
LSM (KPa)	21.68 ± 5.96	23.01 ± 5.24	0.29

P < 0.05 is considered statistical significance. EVs: Esophageal varices; PVSA: Portal vein surface area; PVD: Portal vein diameter; SVD: Splenic vein diameter; CTLV: Actual liver volume measured by computed tomography; CTSV: Actual spleen volume measured by computed tomography; SSV: Standard spleen volume measured by the formula; SLV: Standard liver volume measured by the formula; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; LSM: Liver stiff measurement.

Table 4 Multivariate analysis of parameters of patients with esophageal varices and without esophageal varices

Parameter	Patients with	Patients without	P value
	EVs (n = 86)	EVs (n = 25)
PVSA (mm3)	211.96 ± 69.98	175.16 ± 77.43	0.15
PVD (mm)	13.76 ± 2.48	12.94 ± 2.73	0.02
SVD (mm)	9.54 ± 3.86	7.16 ± 3.36	0.15
CTLV (cm3)	913.54 ± 312.89	1241.92 ± 34.83	0.01
CTSV(cm3)	787.78 ± 399.46	439.23 ± 126.25	0.02
Rate of liver volume change	-0.12 ± 0.55	0.12 ± 0.48	0.11
Rate of spleen volume change	3.46 ± 2.49	1.38 ± 2.73	0.04
Liver volume change (cm3)	135.85 ± 334.26	112.05 ± 280.68	0.03
Spleen volume change (cm3)	243.52 ± 163.89	611.33 ± 293.17	> 0.05

P < 0.05 is considered statistical significance. EVs: Esophageal varices; PVSA: Portal vein surface area; PVD: Portal vein diameter; SVD: Splenic vein diameter; CTLV: Actual liver volume measured by computed tomography; CTSV: Actual spleen volume measured by computed tomography.

Table 5 Parameters used to establish the non-invasive prediction model

Parameter	B	S.E	Wals	df	Sig.	Exp (B)	95%CI of EXP (B)
PVD (mm)	-0.216	0.184	1.384	1	0.239	0.806	0.562-1.155
CTLV (cm3)	-0.013	0.004	9.465	1	0.002	0.987	0.979-0.995
CTSV (cm3)	0.016	0.006	7.047	1	0.008	1.016	1.004-1.028
Rate of spleen volume change	-1.929	0.895	4.646	1	0.031	0.145	0.025-0.839
liver volume change (cm3)	0.009	0.004	5.112	1	0.024	1.009	1.001-1.016
Constant	12.925	4.414	8.573	1	0.003	410393

PVD: Portal vein diameter; CTLV: Actual liver volume measured by computed tomography; CTSV: Actual spleen volume measured by computed tomography; df: Degree of freedom; CI: Confidence interval.

Table 6 Comparison of various parameters of each model

	AUC	Standard error	Sig.	95%CI of EXP(B)
				Lower limit	Upper limit	Sensitivity	Specificity	Youden index
New model	0.873	0.040	0.000	0.795	0.951	0.653	0.897	0.55
LSPS	0.757	0.053	0.000	0.652	0.861	0.667	0.759	0.426
VRI	0.757	0.053	0.000	0.653	0.862	0.647	0.828	0.475
APRI	0.607	0.074	0.120	0.462	0.753	0.696	0.552	0.248
AAR	0.627	0.073	0.067	0.483	0.770	0.588	0.793	0.381

CI: Confidence interval; LSPS: Liver stiffness-spleen diameter to platelet ratio score; VRI: Variceal risk index; APRI: Aspartate transaminase to platelet ratio index; AAR: Aspartate transaminase/Alanine aminotransferase ratio.

Table 7 Comparison of accuracy of each model in predicting esophageal varices of patients in the modeling group

	Accuracy, %	Positive predictive value, %	Negative predictive value, %	Cutoff value
New model	62.2	66.3	47.0	0.849
LSPS	52.2	52.2	36.0	3.77
VRI	47.8	52.3	38.5	0.029
APRI	53.2	62.8	20.0	1.17
AAR	45.0	41.9	44.0	1.43

LSPS: Liver stiffness-spleen diameter to platelet ratio score; VRI: Variceal risk index; APRI: Aspartate transaminase to platelet ratio index; AAR: Aspartate transaminase/Alanine aminotransferase ratio.