Plasma soluble CD 163 level as a marker of oesophageal varices in cirrhotic patients

Abstract

Background: Variceal bleeding (VB), the most common lethal complication of cirrhosis, associated with high mortality. Timely prediction of esophageal varices (EV) represents a real challenge for the medical team. This study evaluated the level of plasma soluble CD 163 as a marker of the presence of EVs and to compare it with other noninvasive clinical, laboratory and ultrasonographic parameters as well as endoscopy. Methods: This prospective controlled study was conducted on 80 adults. Gp I had no oesophageal varices, gp II had small varices, gp IIIa had large varices, gp IIIb are the same patients of gp IIIa but after eradication of varices and gp IV as healthy controls. Serum samples were assayed for soluble CD 163. Results: soluble CD163 was statistically significant different between controls and all liver cirrhosis. it showed a statistically significant difference between group I and II (p = 0.009) and between group I and IIIa (p < 0.001) and between group II and IIIa (p < 0.001) but, no difference between group IIIa and IIIb (p = 0.179). Conclusion:Serum soluble CD163 is a good noninvasive predictor for the presence of EVs and it may be used for grading of EVs. Its level does not change after esophageal varices eradication.

Soluble CD163 for Prediction of High-Risk Esophageal Varices and Variceal Hemorrhage in Patients with Liver Cirrhosis

“…Agha et al [54] identified a PSR of 792 as the best cutoff value for the presence of EV in patients with compensated HCV-related cirrhosis and suggested that a greater ratio could be useful to identify patients at low risk of having EV on endoscopic surveillance. A modestly lower cutoff value was reported in other studies yielding good sensitivities and specificities for prediction of EV in cirrhotic patients, but it did not appear to predict the grade of varices [35, 55]. Excitingly, an Egyptian study used a cut-off value of 1,326.58 for the PSR to predict EV in HCV-related cirrhosis at 96.34% sensitivity and 94% diagnostic accuracy [56].…”

“…An Egyptian study found that the mean serum sCD163 level in cirrhotic patients with and without EV was increased fairly 3 times more than that of the control group and nearly doubled in patients with EV than patients without varices ( p = 0.001); hence, it could potentially predict the presence of EV in Child-Pugh class A cirrhotic patients [34]. Another study found that serum sCD163 is a good noninvasive predictor for the presence of EV and may be used to determine the grade of varices [35]. It showed that the median serum sCD163 concentration was significantly elevated in cirrhotic patients with and without EV compared to healthy subjects ( p = 0.009) and significantly higher in patients with large-size EV compared to patients with small-size varices ( p < 0.001).…”

“…Another study suggested a cutoff value of APRI >0.16 for the detection of EV and prediction of large EV [46]. Nevertheless, other studies found that the mean APRI was not significantly different between cirrhotic patients with small EV and those with large EV, and hence unable to predict the grade of EV, although it could identify varices [34, 35]. A retrospective study of a cohort of cirrhotic and noncirrhotic patients with acute UGIB evaluated APRI, among other noninvasive parameters, as predictors of VH [37].…”

“…A much lower FIB-4 cutoff value at 2.8 was proposed in another study for predicting EV with a PPV of 92.7%, yielding 76% sensitivity and 80% specificity [47]. Nevertheless, other studies found that the mean FIB-4 was not discriminative between small and large EV, and hence unable to predict the variceal grade, although a high FIB-4 could potentially predict the presence of varices [34, 35]. Morishita et al [48] included patients with HCV-related cirrhosis in a study to assess the clinical usefulness of acoustic radiation force impulse and other noninvasive parameters in the diagnosis of EV presence and risk.…”