Abstract: Objective The aim of this study was to investigate efficacy of liver stiffness measurement (LSM) in combination with fibrosis-4 (FIB-4) index and serum chitinase-3-like protein 1 (CHI3L1) levels in predicting esophageal varices (EV) in patients with hepatitis B-induced liver cirrhosis (LC). Methods A total of 123 patients with hepatitis B-induced liver cirrhosis were enrolled in this study between January 2023 and January 2025, and all patients underwent gastroscopy to record occurrence of EV. LSM was measured by Fibro Scan502, FIB-4 index was calculated based on clinical laboratory indexes, and serum CHI3L1 level was determined by ELISA. The receiver operating characteristic (ROC) curve was employed to evaluate the predictive efficacy. Results Gastroscopy found EV in 74 cases (60.2%), and no obvious EV in another 49 cases (39.8%) out of our 123 patients; LSM, FIB-4 index and serum CHI3L1 level in patients with EV were (16.7±3.8)kPa, (5.7±1.4) and (151.4±41.8)ng/ml, all much higher or greater than [(13.1±3.0)kPa, (4.5±1.0) and (122.5±20.2)ng/ml,respectively, P＜0.05] in those without EV; LSM, FIB-4 index and serum CHI3L1 level in 15 patients with severe EV were (19.5±3.9)kPa, (6.7±1.4) and (177.6±42.0)ng/ml,all much higher or greater than [(15.5±3.8)kPa, (5.1±1.5) and (141.4±41.7)ng/ml,respectively, P＜0.05] in 33 patients with mild EV or [(16.4±3.9)kPa, (5.7±1.3) and (148.9±42.0)ng/ml,respectively, P＜0.05] in 26 patients with moderate EV; ROC analysis showed that the AUC was 0.846(95%CI:0.770-0.905),with sensitivity and specificity of 68.9% and 83.7%, respectively, when LSM was combined with FIB-4 index and serum CHI3L1 level in predicting existence of EV in patients with LC. Conclusion The combination of LSM, FIB-4 index and serum CHI3L1 level exhibit a promising predictive efficacy for EV occurrence in patients with hepatitis B-induced LC, which warrants further clinical verification.

Key words: Liver cirrhosis, Esophageal varices, Liver stiffness measurement, Fibrosis-4 index, Chitinase-3-like protein 1, Diagnosis