Original article

Value of aMAP, APRI, FIB-4 and liver stiffness in predicting the degree of esophageal and gastric varices in patients with hepatitis B cirrhosis

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  • Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2023-02-13

  Online published: 2023-08-31

Abstract

Objective: To explore the predictive value of age-male-ALBI-platelets (aMAP), aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis index based on the 4 factors (FIB-4) and liver stiffness measurement (LSM) on the degree of esophageal and gastric varices (EGV) in patients with hepatitis B cirrhosis. Methods: One hundred and fourteen patients with hepatitis B cirrhosis in Shanghai Ruijin Hospital from April 2018 to May 2022 were enrolled. Examinations including liver function, blood routine, LSM and gastroscopy were performed. aMAP, APRI, and FIB-4 were calculated using the calculation formulas of each model. Based on the results of gastroscopy, the patients were divided into four groups: non-EGV group (39 cases), mild EGV group (30 cases), moderate EGV group (23 cases) and severe EGV group (22 cases), and aMAP, APRI, FIB-4 between groups were compared. The receiver operator characteristic curve (ROC curve) was used to analyze the predictive value of aMAP, APRI, FIB-4 and LSM on the degree of EGV in patients with hepatitis B cirrhosis. Results: The aMAP, APRI, FIB-4 and LSM of patients with EGV groups (including mild, moderate and severe EGV groups) were significantly higher than those of the non-EGV group (P<0.05). The area under ROC (AUROC) of aMAP for evaluating the degree of EGV was 0.76, with sensitivity of 85.9% and specificity of 65.7%. The AUROC of APRI, FIB-4 and LSM for evaluating the degree of EGV were 0.86, 0.85 and 0.79 respectively, and the sensitivities were 81.30%, 82.80% and 88.40% respectively, and the specificities were 82.90%, 77.10% and 66.80% respectively. aMAP, APRI, FIB-4 and LSM have a good predictive value for EGV in patients with liver cirrhosis (P<0.05). Compared with the aMAP, APRI, FIB-4 and LSM in patients with mild, EGV, the aMAP, APRI and FIB-4 of patients with moderate and severe of EGV were significantly different (P<0.05). There was a significant difference in LSM between mild EGV group and moderate-severe group (P<0.05). aMAP, APRI and FIB-4 have certain predictive values for the degree of EGV in hepatitis B cirrhosis patients (P<0.05), with decreased sensitivi-ty and specificity. Conclusions: aMAP, APRI, FIB-4 and LSM are of high predictive value for the presence of EGV in patients with hepatitis B cirrhosis. aMAP, APRI and FIB-4 have certain predictive values for the degree of EGV and can be used as a supplementary method for the evaluation of EGV by invasive gastroscopy, and can provide the basis for the prevention and treatment of EGV.

Cite this article

AN Baoyan, GUO Qing, FENG Mingyang, XU Yumin, CAI Wei, XIE Qing, WANG Hui . Value of aMAP, APRI, FIB-4 and liver stiffness in predicting the degree of esophageal and gastric varices in patients with hepatitis B cirrhosis[J]. Journal of Diagnostics Concepts & Practice, 2023 , 22(02) : 141 -146 . DOI: 10.16150/j.1671-2870.2023.02.006

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