Abstract: Objective The aim of this study was to investigate the diagnostic performance of liver stiffness measurement (LSM), platelet count (PLT) / spleen thickness (ST) ratio and splenic vein diameter (SVD) in predicting esophageal varices (EV)in patients with liver cirrhosis (LC). Methods We collected 94 patients with LC, and all patients completed gastroscopy and endoscopic ultrasonography. The EV were divided into non-EV (NEV), mild, moderate, and severe EV, the periesophageal varices (peri ECV) were divided into no peri ECV, mild and severe peri ECV, and the collateral esophageal veins (para-ECV) were divided into non-para-ECV, mild and severe para-ECV. The receiver operating characteristic (ROC) curve was applied to evaluate the predictive performance. Results The ST, SVD and LSM in patients with moderate and severe EV were significantly higher in patients with NEV (P<0.05), and the PLT counts and PLT/ST ratio were significantly lower in with NEV(P<0.05); the PLT and PLT/ST ratio in patients with severe peri-ECV were significantly lower than in patients without or with mild peri-ECV (P<0.05), while the SVD and LSM were significantly higher than in with mild peri-ECV (P<0.05); the PLT counts and PLT/ST ratio in patients with mild and severe para-ECV decreases greatly, while the ST, SVD and LSM increased greatly compared to in patients without para-ECV (P＜0.05); the ROC analysis showed that the AUROC was 0.754 by LSM in predicting EV, much superior to PLT/ST ratio or SVD(the AUROCs were 0.738 and 0.679, respectively); the predictive efficacy of PLT/ST ratio, LSM and SVD for peri-ECV were all poor with the AUROCs<0.600; the predictive efficacy of PLT/ST ratio in judging para-ECV was much superior to LSM or SVD(the AUROC was 0.794 vs. 0.669 or 0.685). Conclusion The LSM has a certain predictive efficacy for EV, and the PLT/ST ratio also has some efficacy for ECV in patients with LC, which might be applied for screening in clinical practice.

Key words: Liver cirrhosis, Esophageal varices, Liver stiffness measurement, Platelet, Spleen thickness, Splenic vein diameter, Diagnosis