External Validation of the Platelet Count/Spleen Diameter Ratio for the Diagnosis of Esophageal Varices in Hepatitis C Virus-Related Cirrhosis

Abstract

In patients with HCV-related cirrhosis, the platelet count/spleen diameter may be proposed as a non-invasive tool for EV diagnosis, especially in financially deprived developing countries.

Noninvasive prediction of large esophageal varices in liver cirrhosis patients

“…Liver cirrhosis-associated portal hypertension causes splenomegaly and hypersplenia and resultant decreases in platelet count and hemoglobin level. Indeed, platelet count/spleen diameter has been shown to be robust in variceal prediction [13,[15][16][17][20][21][22]. Our data are consistent with these reports and further demonstrate a more powerful predictive function for large esophageal varices by pooling these variables together.…”

“…Since variceal screening causes considerable endoscopic burden and cost, seeking a less expensive, noninvasive means for accurate prediction of large esophageal varices has great clinical importance. e promising predictive marks have been focusing on common laboratory variables such as platelet count [16,17] and albumin level [14], ultrasound parameters such as spleen and portal vein dimension [13,17], or data from some minimally invasive approaches such as video capsule endoscopy [18] and computerized tomography [19]. A screening test must be simple and inexpensive, and while some tests are clearly preferable to patients because of ??…”

Non Invasive Diagnosis of Esophageal Varices: Can it Replace Screening Endoscopy?

“…Agha et al,(2009) 31 studied114 compensated cirrhotic patients with hepatitis C, they reported that a cut-off value of 909 (NPV=100% and PPV= 93.8%) was effective in the diagnosis of EV. Baig et al, (2008) in their study stated that a cut-off value of 1014can predict presence of OV.…”

Platelet Count/Spleen Diameter Ratio and Shear-Wave Elastography for Non-Invasive Prediction of High-Risk Varices: Can We Delay Screening Endoscopy for Compensated Cirrhosis?

“…One other non-invasive means is the Platelet Count (PC)/Spleen Diameter (SD) ratio (PC/SD) based on a regular laboratory result and an imaging parameter, which are already available for cirrhotic patients. Since an initial report in 2003 by Giannini et al (11), a number of studies have investigated the accuracy of PC/SD linking to the presence of OVs in cirrhotic patients (12)(13)(14)(15).…”

“…5 0.981) with the cut-off 909 for the presence of OVs in ChildPugh A-C cirrhotic patients (11). The PC/SD ratio 909 cut-off has been prospectively validated in independent cohorts reporting NPV s of 73% to 100% and PPVs of 74% to 93.8% (12,15,32). Also, different cut-offs ranging from 666 to 1014 were proposed with a variety of accuracy values (0.78 to 0.942) for the PC/SD ratio model (13,14,(33)(34)(35).…”