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Diagnostic accuracy of hepatic venous pressure gradient measurement in the prediction of stage 1 compensated liver cirrhosis in patients with chronic hepatitis B

Suk, Ki Taea; Kim, Heung Cheolb; Namkung, Sookb; Han, Sang Hakc; Choi, Kyung Chanc; Park, Seung Hae; Sung, Ho Taikg; Kim, Chang Hoonh; Kim, Seong Hoona; Ham, Young Limf; Kang, Hee Mod; Kim, Dong Joona

European Journal of Gastroenterology & Hepatology: October 2013 - Volume 25 - Issue 10 - p 1170–1176
doi: 10.1097/MEG.0b013e3283613139
Original Articles: Hepatitis

Objective Hepatic venous pressure gradient (HVPG) of 6–10 mmHg has been accepted as a hemodynamic parameter of stage 1 compensated liver cirrhosis (LC). The diagnostic accuracy of HVPG in the prediction of stage 1 compensated LC has been investigated in patients with chronic hepatitis B (CHB).

Methods A total of 219 patients with CHB who underwent HVPG and liver biopsy were enrolled. The diagnostic accuracy of two methods was compared. Risk factors associated with the diagnosis of stage 1 compensated LC on the basis of the findings of HVPG, biopsy, and both HVPG and biopsy were evaluated.

Results The HVPG score was correlated positively with the stage of biopsy (r=0.439). The sensitivity/specificity of HVPG for predicting stage 1 compensated LC were 78/81% in 6 mmHg, respectively. A total of 57 (26%), 28 (13%), and 20 (9%) patients were diagnosed with stage 1 compensated LC on the basis of the findings of HVPG, biopsy, and both HVPG and biopsy (P>0.05), respectively. Platelet/age (−0.77–0.01×platelet+0.03×age), albumin/platelet (5.05−1.19×albumin−0.01×platelet), and platelet (0.24−0.01×platelet) were found to be risk factors (logit model) for the diagnosis of stage 1 compensated LC on the basis of the findings of HVPG, biopsy, and both HVPG and biopsy.

Conclusion HVPG showed a positive correlation with biopsy, and platelet was found to be a common risk factor for the diagnosis of stage 1 compensated LC in patients with CHB.

Departments of aInternal Medicine

bRadiology

cPathology

dFinance and Information Statistics, College of Medicine, Hallym University, Chuncheon

eDepartment of Internal Medicine, Inje University College of Medicine, Busan

fDepartment of Emergency Medical Technology, Daewon University College, Jecheon, South Korea

gDepartment of Biology, Stanford University, Stanford, California

hCollege of Medicine, Upstate Medical University, State University of New York, Syracuse, New York, USA

Ki Tae Suk and Heung Cheol Kim contributed equally to the writing of this article.

Correspondence to Dong Joon Kim, MD, PhD, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Gyo-dong, 200-704 Chuncheon, South Korea Tel: +82 33 240 5647; fax: +82 33 241 8064; e-mail: djkim@hallym.ac.kr

Received December 13, 2012

Accepted March 12, 2013

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins