Abstract: Objective The aim of this study was to investigate endoscopic glue injection and/or esophageal variceal ligation (EVL) in the treatment of patients with liver cirrhosis complicated with esophageal and gastric variceal bleeding (EGVB). Methods 86 patients with liver cirrhosis complicated with EGVB were encountered in our hospital between December 2021 and December 2024, and all were treated with endoscopic tissue glue injection and/or EVL. After 1 year of follow-up, the rebleeding was recorded. Routine clinical tests and examinations were performed to calculate fibrinogen-to-albumin ratio (FAR), neutrophil-to-lymphocyte ratio (NLR) and platelet count/spleen length diameter ratio (PC/SD). Results By end of 12 months of follow-up, rebleeding occurred in 37 cases (43.0%) in the 86 patients with liver cirrhosis after endoscopic treatment; percentage of Child-Pugh class C, INR, FAR and NLR in patients with re-bleeding were 100.0%, (1.4±0.2), (0.05±0.01) and 3.8(2.6,7.4), all significantly higher or greater than [42.9%, (1.2±0.1), (0.03±0.01) and 2.2(1.6,5.3),respectively, P<0.05],while PC/SD ratio was 428.3(338.4,568.5),significantly lower than [786.3(382.5,1028.8),P<0.05] in those without re-bleeding;multivariate Logistic regression analysis showed that PC/SD ratio (OR=0.532,95%CI:0.369-0.765) was protective factor for(P<0.05),while Child-Pugh class (OR=3.710,95%CI:1.267-10.860), INR(OR=5.631,95%CI:2.088-15.185), FAR(OR=2.358,95%CI:1.262-4.407) and NLR(OR=1.619,95%CI:1.167-2.246) were independent risk factors for re-bleeding in patients with EGVB after endoscopic treatment (P<0.05);ROC analysis demonstrated that the AUC was 0.929(95%CI:0.869-0.989), with sensitivity of 89.2% and specificity of 89.8%, when FAR was combined with NLR and PC/SD ratio in predicting re-bleeding. Conclusion Utility of FAR, NLR and PC/SD ratio combination has to some extent clinical value in predicting rebleeding in patients with liver cirrhosis complicated with EGVB after endoscopic treatment, which needs further investigation.

Key words: Liver cirrhosis, Esophageal and gastric variceal bleeding, Endoscopic glue injection, Esophageal variceal ligation, Re-bleeding, Prediction