The predictive value of PC/SD ratio in evaluating the high-risk gastroesophageal varices in patients with hepatitis B virus-related cirrhosis

Abstract

Abstract: Objective To investigate the value of platelet count to spleen diameter (PC/SD) ratio in predicting the high-risk gastroesophageal varices (GEV) in patients with hepatitis B virus (HBV)-related cirrhosis. Methods The patients with HBV-related cirrhosis from January 2018 to December 2020 were divided into a high-risk group and a low-risk group, according to the severity of liver disease and endoscopic performance. The influencing factors of high-risk GEV were analyzed by univariate analysis. Then logistic regression analysis was used to screen out the non-invasive indicators, and diagnostic efficiency were evaluated by receiver operator characteristic (ROC) curve. Results A total of 68 patients were enrolled. Univariate analysis showed that the differences of PC/SD ratio (t=4.141,P<0.01), hemoglobin (t=2.829,P<0.01), platelet count (t=3.324,P<0.01), ascites (χ² = 6.530,P<0.05), Child-Pugh classification (χ² = 6.348,P<0.05) and cirrhosis stages (χ² = 24.882,P<0.01) between the high-risk group and low-risk group were statistically significant. Multivariate analysis showed that PC/SD ratio and cirrhosis stages were independent risk factors for high-risk GEV in patients with HBV-related cirrhosis (OR=0.998, 95%CI: 0.996-1.000, P<0.05;OR=14.088, 95%CI: 3.220-61.629, P<0.01). ROC curve analysis showed that the area under the curve (AUC) of PC/SD ratio in predicting high-risk GEV was 0.781 (95%CI: 0.551-0.811), with an optimal threshold of 596. However, the AUC of PC/SD ratio in predicting the absence of high-risk GEV was 0.888 (95%CI: 0.802, 0.973), with an optimal threshold of 632.7. Conclusion PC/SD ratio could be a preliminary screening indicator for GEV in patients with HBV-related cirrhosis. If PC/SD ratio is less than 596, endoscopy is recommended due to the high possibility of high-risk GEV. If the PC/SD ratio is over 632.7, endoscopy screening could be avoided due to the low possibility of high risk GEV.

Key words: HBV-related cirrhosis, Gastroesophageal varices, Platelet count to spleen diameter ratio, Screening

CHEN Ying, FANG Qing-qing, CHEN Wei, ZHANG Jun-pei, SHEN Dan-jie, YU Li, JIAN You-rong, LI Feng, WANG Jian, CHEN Shi-yao. The predictive value of PC/SD ratio in evaluating the high-risk gastroesophageal varices in patients with hepatitis B virus-related cirrhosis[J]. Chinese Hepatolgy, 2022, 27(2): 164-168.

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