Objective This study aims to assess esophageal varices (EV) by noninvasive parameters in patients with liver cirrhosis. Background The current guidelines recommend the screening of all cirrhotic patients by endoscopy for EV, but repeated endoscopic examinations are unpleasant for patients and have a high cost impact and burden on endoscopic units. Therefore, there is a particular need for noninvasive predictors of EV. Patients and methods A total of 120 cirrhotic patients were enrolled in this study and were divided into three groups: 40 cirrhotic patients with EV and a history of upper gastrointestinal bleeding, 40 cirrhotic patients with EV without a history of upper gastrointestinal bleeding, and 40 cirrhotic patients without EV. All patients in the study were subjected to an assessment of history, clinical examination, routine laboratory investigation, abdominal ultrasound, and upper gastrointestinal endoscopy. Results Serum albumin at cut-off less than 3.65 g/dl, platelet count at cut-off less than 99 000/mm3, platelet count/spleen diameter ratio (PC/SD) at cut-off less than 919.6, aspartate aminotransferase-to-platelet ratio index at cut-off greater than 1.14, spleen longitudinal diameter at cut-off more than 140.5 mm, portal vein diameter at cut-off more than 15.2 mm, and prothrombin time at cut-off more than 15.1s are significant in the prediction of EV. North Italian Endoscopy Club Index at cut-off more than 25.4, platelet count at cut-off less than 74 000/mm3, and PC/SD at cut-off 851.6 are significant in the prediction of variceal bleeding risk. Conclusion Serum albumin, platelet count, PC/SD ratio, aspartate aminotransferase-to-platelet ratio index, spleen longitudinal diameter, portal vein diameter, prothrombin time, and Child score can provide information that can help in the prediction of the presence of EVs in patients with liver cirrhosis. North Italian Endoscopy Club Index, platelet count, and PC/SD ratio can provide information that can help in the prediction of variceal bleeding risk in patients with liver cirrhosis.

Background: Osteopontin is an important tumor marker, since it presents as an immobilized extracellular matrix molecule in addition to present as a secreted form in body fluids involving plasma. Osteopontin levels in the plasma were found to be significantly higher in Hepatocellular Carcinoma (HCC) patients than in healthy control individuals and also higher than in patients with chronic liver diseases. Aim of Study:The aim of the present study is to evaluate the role of plasma OPN level as potential markers of HCC among HCV infected patients, compared to AFP. Also, its relationship with clinicopathological features of HCC patients.Study Design: This is a retrospective case control study. Subjects and Methods:The study included 100 adult subjects; they were classified in to 4 groups: Group 1: It included 30 apparently healthy individuals (control group). Group 2: It included 30 patients with HCV positive chronic hepatitis. Group 3: It included 20 patients with HCV positive liver cirrhosis without HCC. Group 4: It included 20 patients with HCV positive liver cirrhosis and HCC. Serum Osteopontin was measured by Enzyme-Linked Immunosorbent Assay ELISA. Results:The mean OPN level was (33.1 ± 16.4) ng/ml, (27.8± 13.8) ng/ml, (92.87 ± 18.5) ng/ml and (232.13 ±59.7) ng/ml for control, HCV, cirrhosis and HCC groups respectively, p-value=0.0010 and there were highly statistical significant differences between the four groups ( p<0.001). The mean AFP level was (4.6±2.4) ng/ml, (8.01 ±2.76) ng/ml, (24.8±25.9) ng/ml and (639±2226.8) ng/ml for control, HCV, cirrhosis and HCC groups respectively, p-value=0.0014 and there were highly statistical significant differences between the four groups (p<0.001). Conclusion:OPN can be used for diagnosis of HCC and differentiation between HCC and CLD, OPN has higher sensitivity and specificity than AFP and can be used for early diagnosis. Combination of OPN wih AFP has increased both sensitivity and specificity for detection of HCC.

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