Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2022; 10(32): 11743-11752
Published online Nov 16, 2022. doi: 10.12998/wjcc.v10.i32.11743
Non-invasive model for predicting esophageal varices based on liver and spleen volume
Long-Bao Yang, Gang Zhao, Xin-Xing Tantai, Cai-Lan Xiao, Si-Wen Qin, Lei Dong, Dan-Yan Chang, Yuan Jia, Hong Li
Long-Bao Yang, Gang Zhao, Xin-Xing Tantai, Cai-Lan Xiao, Lei Dong, Dan-Yan Chang, Yuan Jia, Hong Li, Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
Si-Wen Qin, Department of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
Author contributions: Yang LB, Zhao G and Dong L designed the research study; Tan-tai XX and Xiao CL performed the research; Jia Y and Chang DY contributed new reagents and analytic tools; Qing SW and Li H analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Supported by Key Research and Development Plan of Shaanxi Province, No. 2020SF-222.
Institutional review board statement: The study was approved by the Ethics Committee of Xi’an Jiaotong University, Shaanxi, China (NO. 2017-445).
Informed consent statement: Informed consent was waived by the Ethics Committee of Xi’an Jiaotong University as patients were identified retrospectively, according to institutional review board exempt protocols.
Conflict-of-interest statement: There are no conflicts of interest to declare.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at hongli119@hotmail.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong Li, MD, Doctor, Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xi'an 710004, Shaanxi Province, China. hongli119@hotmail.com
Received: August 28, 2022
Peer-review started: August 28, 2022
First decision: October 4, 2022
Revised: October 7, 2022
Accepted: October 18, 2022
Article in press: October 18, 2022
Published online: November 16, 2022
Abstract
BACKGROUND

Upper endoscopy is the gold standard for predicting esophageal varices in China. Guidelines and consensus suggest that patients with liver cirrhosis should undergo periodic upper endoscopy, most patients undergo their first upper endoscopy when esophageal variceal bleeds. Therefore, it is important to develop a non-invasive model to early diagnose esophageal varices.

AIM

To develop a non-invasive predictive model for esophageal varices based on liver and spleen volume in viral cirrhosis patients.

METHODS

We conducted a cross-sectional study based on viral cirrhosis crowd in the Second Affiliated Hospital of Xi'an Jiaotong University. By collecting the basic information and clinical data of the participants, we derived the independent risk factors and established the prediction model of esophageal varices. The established model was compared with other models. Area under the receiver operating characteristic curve, calibration plot and decision curve analysis were used to test the discriminating ability, calibration ability and clinical practicability in both the internal and external validation.

RESULTS

The portal vein diameter, the liver and spleen volume, and volume change rate were the independent risk factors of esophageal varices. We successfully used the factors to establish the predictive model [area under the curve (AUC) 0.87, 95%CI: 0.80-0.95], which showed better predictive value than other models. The model showed good discriminating ability, calibration ability and the clinical practicability in both modelling group and external validation group.

CONCLUSION

The developed non-invasive predictive model can be used as an effective tool for predicting esophageal varices in viral cirrhosis patients.

Keywords: Gastroscopy, Esophageal varices, Liver volume, Cirrhosis, Non-invasive diagnostic model, Spleen volume

Core Tip: An effective novel non-invasive predictive model based on the standard liver and spleen volume formula for esophageal varices in individuals with viral cirrhosis was developed. The model's specificity, calibrability, and clinical efficacy were superior to other models.