关键词: 肝硬化, 食管静脉曲张, 脾脏体检, 肝纤维化-4因子, 血管内皮生长因子, 诊断

Abstract: Objective The purpose of this study was to investigate the diagnostic performance of computed tomography (CT)-detected parameters and fibrosis-4 (FIB-4) and serum vascular endothelial growth factor (VEGF) levels in predicting esophageal varices (EV) in patients with hepatitis B-induced liver cirrhosis (LC). Methods 98 patients hepatitis B-induced LC were admitted to our hospital between March 2020 and April 2023, and all patients underwent gastroscopy to find EV. The CT examination was conducted to measure the liver and spleen volumes, and the main portal vein (MPV), the splenic vein (SPV) and the left gastric vein (LGV) diameters. The FIB-4 was calculated, and serum VEGF levels were measured by ELISA. The receiver operating characteristic (ROC) curve was plotted, and the diagnostic performance was evaluated based on the area under the curve (AUC). Results Out of the 98 patients with LC in our series, the gastroscopy found EV in 48 cases; the volume of spleen, the MPV and the LGV in patients with EV were (581.7±98.6)cm³, (15.2±1.3)mm and (6.1±0.5)mm, all significantly higher than [(452.6±84.9)cm³, (12.1±0.8)mm and (4.2±0.3)mm, respectively, P<0.05] in those without EV; the FIB-4 score and serum VEGF level were (6.0±1.3) and (101.7±28.1)ng/L, both significantly higher than [(4.3±0.9) and (65.7±15.7)ng/L, P<0.05] in patients without EV; the AUC was 0.967(95% CI:0.931-0.997), with sensitivity of 91.8% and the specificity of 90.0%, when the combination of the spleen volume, MPV, LGV, FIB-4 and serum VEGF level was applied to predict the existence of EV. Conclusion The CT measured parameters of portal veins and FIB-4 and serum VEGF levels in predicting EV in patients with LC could achieve a promising diagnosing performance, which might help the clinicians make an appropriate managements.

Key words: Liver cirrhosis, Esophageal varices, Spleen volume, Fibrosis-4, Vascular endothelial growth factor, Diagnosis