Comparative Study between Right Liver Lobe Diameter/Albumin Ratio and Platelet Count/Spleen Diameter Ratio as a Non-Invasive Predictor of Oesophageal Varices in Patients with Liver Cirrhosis
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- Category: Vol. 81, December 2013
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Comparative Study between Right Liver Lobe Diameter/Albumin Ratio and Platelet Count/Spleen Diameter Ratio as a Non-Invasive Predictor of Oesophageal Varices in Patients with Liver Cirrhosis, HAMDY M. MOSTAFA, KHALED A. EID, MONA M. ABDEL MEGUID and SAFIA A. MOHAMED
Abstract
Objective: Oesophageal varices development is among the major complications of liver cirrhosis. Repeated endoscopic examinations are unpleasant for patients, and have cost impact, while only half of cirrhotic patients have varices. For these reasons, non- invasive predictors for the presence and size of varices has been studied.
Aim of the Work: To compare between platelet count/spleen diameter (PC/SD) ratio and right liver lobe diameter/albumin (RLLD/alb) ratio as non-invasive predictors of oesophageal varices and their grading in patients with liver cirrhosis.
Patients and Methods: Fourty patients with liver cirrhosis were included in this study, with oesophageal varices (OV) and 10 without OV as control group. All patients were subjected to the following: Complete blood count including platelet count & liver function test including serum albumin, upper endoscopy and abdominal ultrasound including liver right lobe longest diameter and spleen bipolar diameter. Child-Pugh’s score was calculated.
Results: The PC/SD ratio is significantly decreased and the RLLD/Alb ratio is significantly increased in the all patients with OV and their subgroups than the control group (p=0.001 for each). A significant negative correlations were found between both PC/SD and RLLD/Alb ratios and the size of OV and Child-Pugh's score (p=0.001 for each correlation between PC/SD ratio and size of OV and Child-Pugh’s score and p=0.016 and 0.011 for correlations between RLLD/Alb ratio and size of OV and and Child-Pugh’s score respectively). The sensitivity of PC/SD ratio in the prediction of the size of OV was 96%, the specificity was 91% and the accuracy was 87.2% at a cut off value of 528.6. For RLLD/Alb ratio, the sensitivity was 93%, the specificity was 95% and the accuracy was 96.5% at a cut off value of 4.7.
Conclusion: There is a good correlation between PC/SD and RLLD/Alb ratios and oesophageal varices presence and grades. Further studies are needed on a large number of patients for confirmation of these findings.