Open Journal of Gastroenterology, 2017, 7, 230-242
http://www.scirp.org/journal/ojgas
ISSN Online: 2163-9469
ISSN Print: 2163-9450
DOI: 10.4236/ojgas.2017.78025 Aug. 31, 2017 230 Open Journal of Gastroenterology
Noninvasive Fibrosis Scores as Prognostic
Markers for Varices Needing Treatment in
Advanced Compensated Liver Cirrhosis
Elham Ahmed Hassan
1*
, Abeer Sharaf El-Din Abd El-Rehim
1
, Zain El-Abdeen Ahmed Sayed
2
,
Ahmed Mohmmed Ashmawy
2
, Emad Farah Mohamed Kholef
3
, Abeer Sabry
4
,
Wael Abd-Elgwad Elsewify
5
1
Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt
2
Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
3
Department of Clinical pathology, Faculty of Medicine, Aswan University, Aswan, Egypt
4
Department of Internal Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt
5
Department of Internal Medicine, Faculty of Medicine, Aswan University, Aswan, Egypt
Abstract
Background/purpose: Noninvasive assessment of esophageal varices (EVs), their
size and bleeding stigmata may reduce endoscopic burden, cost and drawbacks.
We aimed to evaluate the diagnostic performance of noninvasive fibrosis scores
(AAR, APRI, FIB-4, King and VITRO scores) in predicting the presence of
EVs and high risk varices needing treatment (VNT) in HCV-related cirrhosis of
Egyptian patients. Methods: This prospective study included 154 HCV-related
advanced compensated cirrhotic patients with no history of bleeding who un-
derwent screening endoscopy for EVs. AAR, APRI, FIB-4, King and VITRO
scores were assessed. Results: Esophageal varices were found in 120 patients
(77.9%) and VNT in 92 patients (59.7%). Apart from AAR, all scores demon-
strated statistically significant correlations with the presence and the size of
EVs. Using area under receiver operating characteristic curve (AUC), these
scores were good predictors for the presence of EVs and VNT, where VITRO
score had the highest AUC (0.920 and 0.900) and accuracy (97.1% and 87%),
sensitivity (75, 82.6%), specificity (100, 93.5%), PPV (100, 95%) and NPV (53.2,
78.4%) with cutoffs >1.3 and >1.8 respectively. Conclusion: Noninvasive fibro-
sis scores can predict the presence of EVs and VNT. VITRO score was the
best predictor with higher accuracy for clinical applicability than studied
scores.
How to cite this paper: Hassan, E.A., Abd
El -Rehim, A.S., Sayed, Z. A., Ashmawy, A.M.,
Kholef, E.F.M., Sabry, A. and Elsewify,
W.A. (2017) Noninvasive Fibrosis Scores as
Prognostic Markers for Varices Needing
Treatment in Advanced Compensated
Liver Cirrhosis. Open Journal of Gastroen-
terology, 7, 230-242.
https://doi.org/10.4236/ojgas.2017.78025
Received: June 23, 2017
Accepted: August 28, 2017
Published: August 31, 2017
Copyright © 2017 by authors and
Scientific Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Open Access