NON-INVASIVE PREDICTORS OF PORTAL HYPERTENSION IN PATIENTS WITH HEPATITIS C VIRUS RELATED HEPATOCELLULAR CARCINOMA | ||||
| Journal of the Egyptian Society of Parasitology | ||||
| Article 9, Volume 45, Issue 3, December 2015, Page 545-554 PDF (280.94 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/jesp.2015.96289 | ||||
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| Authors | ||||
| ZAKARIA MOHRAN1; MOHAMED SAKR1; EMAN BARAKAT1; AHMED ELBAZ1; MOHAMED ABD AL-HAMID1; MOHAMED ABOU-ELMAATY2 | ||||
| 1Department of Tropical Medicine, Gastroenterology and Hepatology, Faculty of Medicine, Ain Shams University, Cairo11566, Egypt. | ||||
| 2Department of Radiology, Faculty of Medicine, Ain Shams University, Cairo11566, Egypt. | ||||
| Abstract | ||||
| The reference standard for portal venous pressure measurement which is clinically important for estimating the feasibility of resection of hepatocellular carcinoma is the hepatic venous pressure gradient, which is invasive and expensive. The present study evaluated the noninvasive parameters for assessment of portal hypertension in Child A patients with hepatocellular carcinoma on top of hepatitis C virus. A total of 112 patients were subjected to clinical assessment, biochemical assay, ultrasonographic Doppler study, triphasic spiral abdominal computed tomography, upper gastrointestinal endoscopy and hepatic venous pressure gradient measurement. According to hepatic venous pressure gradient measurement, they were classified into groups: GI: 58 patients with hepatic venous pressure gradient <10 mmHg and GII: 54 patients with hepatic venous pressure gradient ≥ 10 mmHg. Significant variables in univariate analysis were included in a multivariate analysis to establish a model for prediction of clinically significant portal hypertension. Results showed that portal vein diameter ≥ 1.3 cm, mono or biphasic pattern of flow in hepatic veins and Giannini index ≤ 909 were independent risk factors for the clinically significant portal hypertension as indicated by HVPG ≥ 10 mmHg. A model with highest likelihood ratio and good fitness was created. This prediction model was displayed by the receiver operating characteristic curve and under the curve area was 0.969 (0.938-1). | ||||
| Keywords | ||||
| Hepatocellular carcinoma; Hepatic venous pressure gradient; Portal vein diameter; Hepatic vein; Giannini index | ||||
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