NON-INVASIVE MARKERS PREDICTIVE OF PORTAL HYPERTENSIVE GASTROPATHY IN CIRRHOTIC PATIENTS

Aims Portal hypertensive gastropathy (PHG) is a portal hypertension manifestation which diagnosis relies on upper gastrointestinal endoscopy (UGE). In this study we aimed to evaluate the effectiveness of non-invasive indicators in predicting PHG.

Methods In this single-centre retrospective study, we included all admitted cirrhotic patients between 2008 and 2021. We collected biological and imaging parameters. PHG severity was assessed according to the grading of New Italian Endoscopic Club (NIEC). We also calculated the following scores: FIB-4, APRI, King-score, Lok-score, Liaoning-score, Fibrosis-index, AST/ALT ratio and Platelet/Spleen diameter.

Results We included 200 patients of mean age 56.9 years±15 years and 56% female. PHG was found in 71% of cases. Mild gastropathy was observed in 41, moderate in 71 and severe in 31 patients. Laboratory and sonographic findings were not correlated to PHG, notably platelet count (p=0.56), leukocyte count (p=0.50), haemoglobin (p=0.95), serum-sodium (p=0.95), serum-albumin (p=0.69), serum-creatinine (p=0.40), transaminases (p=0.55, 0.36), total-bilirubin (p=0.72), INR (p=0.85), spleen diameter (p=0.57) and portal vein diameter (p=0.10). Similarly, we found no association between non-invasive scores and PHG when comparing the gastropathy-group to baseline: FIB-4 (7.9−6.8, p=0.21), APRI (2.3−1.8, p=0.12), King-score (85.4−67.4, p=0.08), Lok-score (0.92−0.90, p=0.45), Liaoning-score (0.9 – (−0.2), p=0.08), fibrosis-index (4.4−4.3, p=0.74), AST/ALT (1.8−2.1, p=0.44), Platelet/Spleen diameter (793.3−783.1, p=0.92). However, in subgroup analysis, unlike the other scores, Liaoning-score was checked as significantly associated with severe PHG (severe PHG: 0.36 vs non-severe PHG: (−0.62), p=0.04).

Conclusions In our study, the performance of non-invasive markers was mediocre in predicting PHG presence. Liaoning-score nevertheless was associated with gastropathy severity.

Publication History

Article published online:
14 April 2022