Abstract: Objective The aim of this study was to evaluate the existence of esophageal varices (EV) by two-dimensional shear wave elastography (2D-SWE) technology, fibrosis-4 factor index (FIB-4) and serum vascular endothelial growth factor (VEGF) levels in patients with hepatitis B-induced liver cirrhosis(LC). Methods 117 patients with hepatitis B-induced LC were enrolled in our hospital between June 2020 and June 2023, and they all underwent routine gastroscopy to determine the occurrence of EV. The liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) were detected by 2D SWE technology. The FIB-4 was calculated based on blood biochemical results and demographic data. Serum VEGF level was assayed by ELISA. The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) were calculated to evaluate the diagnostic efficacy of each parameter on EV happening in patients with hepatitis B-induced LC. Results The gastroscopy found EV in 42 cases (35.9%) and no EV in 75 cases (64.1%) in our 117 patients with LC; the LSM, SSM, FIB-4 score and serum VEGF level in patients with EV were (19.4±5.4)kPa, (42.5±9.5)kPa, (4.7±1.6) and (168.6±50.4)pg/mL, all significantly higher than [(14.2±4.7)kPa, (30.9±8.6)kPa,(2.6±0.9) and (130.9±39.3)pg/mL, respectively, P<0.05] in patients without EV; the ROC analysis showed that the AUC was 0.954, with the sensitivity and specificity of 92.0% and 85.7%, respectively, when the LSM, SSM,FIB-4 and serum VEGF level were combined to predict the occurrence of EV (the cut-off-value were 16.0 kPa, 38.8 kPa, 3.7 and 142.9 pg/mL, respectively), much superior to any parameter alone (P<0.05). Conclusion The application of 2D-SWE technology to detect LSM and SSM and their combination of FIB-4 score and serum VEGF level could predict the occurrence of EV in patients with hepatitis B-induced LC, which needs further clinical verification.

Key words: Liver cirrhosis, Esophageal varices, Two-dimensional shear wave elastography, Liver fibrosis-4 factor index, Vascular endothelial growth factor, Diagnosis