Journal of Hepatology
Volume 53, Issue 4 , Pages 630-638 , October 2010

Prediction of oesophageal varices in hepatic cirrhosis by simple serum non-invasive markers: Results of a multicenter, large-scale study

  • Giada Sebastiani

      Affiliations

    • Department of Digestive Diseases, Hepatology and Clinical Nutrition, Dell’Angelo Hospital, Venice, Italy
    • VIMM-Venetian Institute of Molecular Medicine, Padova, Italy
  • ,
  • Diego Tempesta

      Affiliations

    • Department of Digestive Diseases, Hepatology and Clinical Nutrition, Dell’Angelo Hospital, Venice, Italy
  • ,
  • Giovanna Fattovich

      Affiliations

    • Gastroenterology Clinic, Anesthesiological and Surgical Department, University of Verona, Verona, Italy
  • ,
  • Laurent Castera

      Affiliations

    • Service d’Hépato-gastroentérologie, Hôpital Haut Lévêque, C.H.U. Bordeaux, Pessac, France
  • ,
  • Philippe Halfon

      Affiliations

    • Laboratoire Alphabio, Hospital Ambroise Pare, Marseille, France
  • ,
  • Marc Bourliere

      Affiliations

    • Hôpital Saint Joseph, Marseille, France
  • ,
  • Franco Noventa

      Affiliations

    • Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy
  • ,
  • Paolo Angeli

      Affiliations

    • Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy
  • ,
  • Alfredo Saggioro

      Affiliations

    • Department of Digestive Diseases, Hepatology and Clinical Nutrition, Dell’Angelo Hospital, Venice, Italy
  • ,
  • Alfredo Alberti

      Affiliations

    • VIMM-Venetian Institute of Molecular Medicine, Padova, Italy
    • Department of Histology, Microbiology and Medical Biotechnologies, University of Padova, Padova, Italy
    • Corresponding Author InformationCorresponding author. Address: Institute for Molecular Medicine (VIMM), Via Orus 2, 35100 Padova, Italy. Tel.: +39 049 7923224.

Received 6 October 2009 ,Revised 4 April 2010 ,Accepted 6 April 2010.

References 

  1. Jensen DM. Endoscopic screening for varices in cirrhosis: findings, implications, and outcomes. Gastroenterology. 2002;122:1620–1630
  2. Carbonell N, Pauwels A, Serfaty L, Fourdan O, Levy VG, Poupon R. Improved survival after variceal bleeding in patients with cirrhosis over the past two decades. Hepatology. 2004;40:652–659
  3. Amico G, Garcia-Pagan JC, Luca A, Bosch J. Hepatic vein pressure gradient reduction and prevention of variceal bleeding in cirrhosis: a systematic review. Gastroenterology. 2006;131:1611–1624
  4. de Franchis R. Evolving consensus in portal hypertension. Report of the Baveno IV consensus workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol. 2005;43:167–176
  5. de Franchis R. Non-invasive (and minimally invasive) diagnosis of oesophageal varices. J Hepatol. 2008;49:520–527
  6. de Franchis R, Pascal JP, Ancona E, Burroughs AK, Henderson M, Fleig W, et al. Definitions, methodology and therapeutic strategies in portal hypertension. A Consensus Development Workshop, Baveno, Lake Maggiore, Italy, April 5 and 6, 1990. J Hepatol. 1992;15:256–261
  7. Giannini E, Risso D, Botta F, Chiarbonello B, Fasoli A, Malfatti F, et al. Validity and clinical utility of the aspartate aminotransferase-alanine aminotransferase ratio in assessing disease severity and prognosis in patients with hepatitis C virus-related chronic liver disease. Arch Intern Med. 2003;163:218–224
  8. Wai CT, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA, Conjeervaram HS, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 2003;38:518–526
  9. Forns X, Ampurdanes S, Llovet JM, Aponte J, Quinto L, Martinez-Bauer E, et al. Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive model. Hepatology. 2002;36:986–992
  10. Lok AS, Ghany MG, Goodman ZD, Wright EC, Everson GT, Sterling RK, et al. Predicting cirrhosis in patients with hepatitis C based on standard laboratory tests: results of the HALT-C cohort. Hepatology. 2005;42:282–292
  11. Vallet-Pichard A, Mallet V, Nalpas B, Verkarre V, Nalpas A, Dhalluin-Venier V, et al. FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. Comparison with liver biopsy and fibrotest. Hepatology. 2007;46:32–36
  12. Koda M, Matunaga Y, Kawakami M, Kishimoto Y, Suou T, Murawaki Y. Fibroindex, a practical index for predicting significant fibrosis in patients with chronic hepatitis C. Hepatology. 2007;45:297–306
  13. Castera L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology. 2005;128:343–350
  14. DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44:837–845
  15. Hanley JA, McNeil BJ. The meaning and use of the area under a receiving operating characteristic (ROC) curve. Radiology. 1982;143:29–36
  16. Sanyal A, Bosch J, Blei A, Arroyo V. Portal hypertension and its complications. Gastroenterology. 2008;134:1715–1728
  17. Zaman A, Hapke RJ, Flora K, Rosen HR, Benner KG. Changing compliance to the American College of Gastroenterology guidelines for the management of variceal hemorrhage: a regional survey. Am J Gastroenterol. 2004;99:645–649
  18. Sebastiani G, Halfon P, Castera L, Pol S, Thomas DL, Mangia A, et al. SAFE biopsy: a validated method for large-scale staging of liver fibrosis in chronic hepatitis C. Hepatology. 2009;49:1821–1827
  19. Castera L, Bail BL, Roudot-Thoraval F, Bernard PH, Foucher J, Merrouche W, et al. Early detection in routine clinical practice of cirrhosis and oesophageal varices in chronic hepatitis C: comparison of transient elastography (FibroScan) with standard laboratory tests and non-invasive scores. J Hepatol. 2009;50:59–68
  20. Madhotra R, Mulcahy HE, Willner I, Reuben A. Prediction of esophageal varices in patients with cirrhosis. J Clin Gastroenterol. 2002;34:81–85
  21. Sanyal AJ, Fontana RJ, Di Bisceglie AM, Everhart JE, Doherty MC, Everson GT, et al. The prevalence and risk factors associated with esophageal varices in subjects with hepatitis C and advanced fibrosis. Gastrointest Endosc. 2006;64:855–864
  22. Qamar AA, Grace ND, Groszmann RJ, Garcia-Tsao G, Bosch J, Burroughs AK, et al. Platelet count is not a predictor of the presence or development of gastroesophageal varices in cirrhosis. Hepatology. 2008;47:153–159
  23. Imbert-Bismut F, Ratziu V, Pieroni L, Charlotte F, Benhamou Y, Poynard T. MULTIVIRC Group. Biochemical markers of liver fibrosis in patients with hepatitis C virus infection: a prospective study. Lancet. 2001;357:1069–1075
  24. Thabut D, Trabut JB, Massard J, Rudler M, Muntenau M, Messous D, et al. Non-invasive diagnosis of large oesophageal varices with FibroTest in patients with cirrhosis: a preliminary retrospective study. Liver Int. 2006;26:271–278
  25. Vizzutti F, Arena U, Romanelli RG, Rega L, Foschi M, Colagrande S, et al. Liver stiffness measurement predicts severe portal hypertension in patients with HCV-related cirrhosis. Hepatology. 2007;45:1290–1297
  26. Giannini E, Botta F, Borro P, Risso D, Romagnoli P, Fasoli A, et al. Platelet count/spleen diameter ratio: proposal and validation of a non-invasive parameter to predict the presence of oesophageal varices in patients with liver cirrhosis. Gut. 2003;52:1200–1205
  27. Giannini EG, Zaman A, Kreil A, Floreani A, Dulbecco P, Testa E, et al. Platelet count/spleen diameter ratio for the noninvasive diagnosis of esophageal varices: results of a multicenter, prospective, validation study. Am J Gastroenterol. 2006;101:2511–2519

PII: S0168-8278(10)00528-3

doi: 10.1016/j.jhep.2010.04.019

Journal of Hepatology
Volume 53, Issue 4 , Pages 630-638 , October 2010