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Complete blood count reflects the degree of oesophageal varices and liver fibrosis in virus-related chronic liver disease patients

Cited 19 time in Web of Science Cited 17 time in Scopus
Authors
Lee, J. -H.; Yoon, J. -H.; Lee, C. -H.; Myung, S. J.; Kim, B. H.; Kim, W.; Jang, J. J.; Lee, H-S.; Kim, Y. J.; Chung, G. E.; Keam, B.
Issue Date
2009-06
Publisher
WILEY-BLACKWELL PUBLISHING, INC
Citation
JOURNAL OF VIRAL HEPATITIS; Vol.16 6; 444-452
Keywords
complete blood cell countliver fibrosisoesophageal varicesP2/MS
Abstract
To optimize management of chronic liver disease (CLD), a simple and noninvasive test to determine oesophageal varices (EV) and liver fibrosis is necessary. We performed a cohort study in a single tertiary care centre in order to devise a simple index reflecting EV and liver fibrosis. We derived an index reflecting EV which resulted from portal hypertension (the first part) and evaluated the index`s ability to detect liver fibrosis which resulted in portal hypertension (the second part). Five hundred fifty-six patients (the first part, n = 409, mean age = 55.4 years, EV prevalence = 34.0%; the second part, n = 147, mean age = 48.8 years, cirrhosis prevalence = 12.9%) with virus-related CLD were included. P2/MS [(platelet count [10(9)/L])(2)/(monocyte fraction [%] x segmented neutrophil fraction [%])] was derived to detect EV. The area under the receiver-operating characteristic curve (AUROC) of P2/MS was 0.916 (95% confidence interval, 0.879-0.954) for detecting EV, and 0.905 (0.862-0.947) for detecting high-risk EV (grade >= II or with red colour signs). P2/MS had AUROCs of 0.952 (0.904-0.999) and 0.873 (0.792-0.955) for histological cirrhosis (METAVIR F4) and significant fibrosis (METAVIR F2-F4), respectively, which were significantly greater than those of AST-to-platelet count ratio index (0.658, P < 0.001; 0.644, P = 0.003) and FIB-4 (0.776, P = 0.031; 0.707, P = 0.026). The predictive values of P2/MS were maintained at similar accuracy in subsequent validation sets. Our study suggests that P2/MS comprising only the complete blood count results is an efficient and noninvasive marker reflecting the presence of EV and the grade of liver fibrosis in patients with virus-related CLD. An independent external validation of P2/MS is required.
ISSN
1352-0504
Language
English
URI
http://hdl.handle.net/10371/76419
DOI
https://doi.org/10.1111/j.1365-2893.2009.01091.x
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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