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A liver stiffness measurement-based, noninvasive prediction model for high-risk esophageal varices in B-viral liver cirrhosis

DC FieldValueLanguage
dc.contributor.author전재윤-
dc.contributor.author한광협-
dc.contributor.author김도영-
dc.contributor.author김범경-
dc.contributor.author김자경-
dc.contributor.author박준용-
dc.contributor.author백용한-
dc.contributor.author안상훈-
dc.contributor.author이관식-
dc.date.accessioned2015-04-23T16:47:23Z-
dc.date.available2015-04-23T16:47:23Z-
dc.date.issued2010-
dc.identifier.issn0002-9270-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/101229-
dc.description.abstractOBJECTIVES: Periodic endoscopic screening for esophageal varices (EVs) and prophylactic treatment for high-risk EVs ((HEVs); (1) medium/large EVs and (2) small EVs with red sign or decompensated cirrhosis) are currently recommended for all cirrhotic patients. However, if a simple, noninvasive test is available, many low-risk patients may safely avoid endoscopy. We developed and validated a new liver stiffness measurement (LSM)-based prediction model for HEVs. METHODS: We prospectively enrolled 280 consecutive B-viral cirrhosis patients from 2005 to 2007 (training set) and 121 from 2007 to 2008 (validation set). All underwent laboratory workups, endoscopy, LSM, and ultrasonography. For detection of HEVs, univariate and multivariate analysis were performed, using chi2-test/t-test and logistic regression, respectively. A prediction model was derived from multivariate predictors. RESULTS: In the training set, 90 had HEVs, and multivariate analysis showed significant differences in LSM, spleen diameter, and platelet count between patients with and without HEVs. We developed LSM-spleen diameter to platelet ratio score (LSPS): LSM x spleen diameter/platelet count. The area under the receiver-operating characteristic curve (AUROC) in the training set was 0.954. At LSPS<3.5, 94.0% negative predictive value (NPV) was provided (184 patients), whereas 94.2% positive predictive value (PPV) was achieved (69 patients) at LSPS>5.5. Overall, the likelihood of HEVs was correctly diagnosed in 253 patients (90.3%). Its predictive values were maintained at similar accuracy in subsequent validation set (AUROC=0.953; 94.7% NPV/93.3% PPV at cutoff 3.5/5.5, respectively). CONCLUSIONS: LSPS is a reliable, noninvasive method for detection of HEVs. Patients with LSPS<3.5 may avoid endoscopy safely, whereas those with LSPS>5.5 should be considered for appropriate prophylactic treatments-
dc.description.statementOfResponsibilityopen-
dc.format.extent1382~1390-
dc.relation.isPartOfAMERICAN JOURNAL OF GASTROENTEROLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHEsophageal and Gastric Varices/diagnosis*-
dc.subject.MESHEsophageal and Gastric Varices/diagnostic imaging-
dc.subject.MESHEsophagoscopy-
dc.subject.MESHFemale-
dc.subject.MESHHepatitis B/complications*-
dc.subject.MESHHumans-
dc.subject.MESHLiver Cirrhosis/diagnosis*-
dc.subject.MESHLiver Cirrhosis/diagnostic imaging-
dc.subject.MESHLiver Cirrhosis/virology-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPredictive Value of Tests-
dc.subject.MESHReproducibility of Results-
dc.subject.MESHUltrasonography-
dc.titleA liver stiffness measurement-based, noninvasive prediction model for high-risk esophageal varices in B-viral liver cirrhosis-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorBeom Kyung Kim-
dc.contributor.googleauthorKwang-Hyub Han-
dc.contributor.googleauthorJun Yong Park-
dc.contributor.googleauthorSang Hoon Ahn-
dc.contributor.googleauthorJa Kyung Kim-
dc.contributor.googleauthorYong Han Paik-
dc.contributor.googleauthorKwan Sik Lee-
dc.contributor.googleauthorChae Yoon Chon-
dc.contributor.googleauthorDo Young Kim-
dc.identifier.doi10.1038/ajg.2009.750-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA04268-
dc.contributor.localIdA00487-
dc.contributor.localIdA00852-
dc.contributor.localIdA01675-
dc.contributor.localIdA01829-
dc.contributor.localIdA02226-
dc.contributor.localIdA02666-
dc.contributor.localIdA03544-
dc.contributor.localIdA00385-
dc.relation.journalcodeJ00081-
dc.identifier.eissn1572-0241-
dc.identifier.pmid20087336-
dc.identifier.urlhttp://www.nature.com/ajg/journal/v105/n6/full/ajg2009750a.html-
dc.contributor.alternativeNameChon, Chae Yoon-
dc.contributor.alternativeNameHan, Kwang Hyup-
dc.contributor.alternativeNameKim, Do Young-
dc.contributor.alternativeNameKim, Beom Kyung-
dc.contributor.alternativeNameKim, Ja Kyung-
dc.contributor.alternativeNamePark, Jun Yong-
dc.contributor.alternativeNamePaik, Yong Han-
dc.contributor.alternativeNameAhn, Sang Hoon-
dc.contributor.alternativeNameLee, Kwan Sik-
dc.contributor.affiliatedAuthorHan, Kwang Hyup-
dc.contributor.affiliatedAuthorKim, Beom Kyung-
dc.contributor.affiliatedAuthorKim, Ja Kyung-
dc.contributor.affiliatedAuthorPark, Jun Yong-
dc.contributor.affiliatedAuthorPaik, Yong Han-
dc.contributor.affiliatedAuthorAhn, Sang Hoon-
dc.contributor.affiliatedAuthorLee, Kwan Sik-
dc.contributor.affiliatedAuthorChon, Chae Yoon-
dc.contributor.affiliatedAuthorKim, Do Young-
dc.citation.volume105-
dc.citation.number6-
dc.citation.startPage1382-
dc.citation.endPage1390-
dc.identifier.bibliographicCitationAMERICAN JOURNAL OF GASTROENTEROLOGY, Vol.105(6) : 1382-1390, 2010-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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