Performance of Spleen Stiffness, Liver Stifness, and their Combination for Predicting Esophageal among Patient with HBV-Related Cirrhosis

Background: Liver cirrhosis in Indonesia still become a burden disease, and the etiology is mostly from the hepatitis B virus. Esophageal varices (EV) is the most common complication of portal hypertension in liver cirrhosis. Due to many reasons, esophagogastroduodenoscopy is still not fully suitabl...

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Main Authors: Billy Stinggo Siahaan, Juferdy Kurniawan, Marcellus Simadibrata, Aulia Rizka, Andri Sanityoso, Cleopas Martin Rumende, Andhika Rachman, Hamzah Shatri
Format: Article
Language:English
Published: Interna Publishing 2023-11-01
Series:The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
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Online Access:https://ina-jghe.com/index.php/jghe/article/view/909
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author Billy Stinggo Siahaan
Juferdy Kurniawan
Marcellus Simadibrata
Aulia Rizka
Andri Sanityoso
Cleopas Martin Rumende
Andhika Rachman
Hamzah Shatri
author_facet Billy Stinggo Siahaan
Juferdy Kurniawan
Marcellus Simadibrata
Aulia Rizka
Andri Sanityoso
Cleopas Martin Rumende
Andhika Rachman
Hamzah Shatri
author_sort Billy Stinggo Siahaan
collection DOAJ
description Background: Liver cirrhosis in Indonesia still become a burden disease, and the etiology is mostly from the hepatitis B virus. Esophageal varices (EV) is the most common complication of portal hypertension in liver cirrhosis. Due to many reasons, esophagogastroduodenoscopy is still not fully suitable for routine surveillance in daily practice. Hence, studies that work in the search for the best non-invasive test are still important for predicting EV. Method: A total of 71 patients with liver cirrhosis due to hepatitis B who had undergone endoscopy, spleen stiffness measurement (SSM), and liver stiffness measurement (LSM), between January–April 2023 were enrolled. Diagnostic applicability was assessed by the area under the receiver-operator curve (AUC) to measure and compare the performance of each measurement and combination for predicting EV and to obtain the corresponding optimal prediction value. Results: This study was participated by 71 subjects with liver cirrhosis. The prevalence of Child-Pugh A was 74.6% (53 patients), Child-Pugh B 22.5% (16 patients), and 2.8% (2 patients) with Child-Pugh C. Among these patients, the proportion of EV was 71.8%. This study showed that SSM with a cut-off of 38.8 kPa had AUC 0.867 (95% CI: 0.774–0.960) (sensitivity 78.4%, specificity 80%) and LSM with a cut-off of 10.55 kPa had AUC 0.822 (95% CI: 0.701–0.943) (sensitivity 88.2%, specificity 65%). Conclusion: Spleen stiffness and liver stiffness measurements have a good performance for predicting EV in patients with liver cirrhosis caused by hepatitis B.
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spelling doaj-art-ca6f9bc9c1a3436aa1a71e5c6f4b980d2025-08-20T03:13:36ZengInterna PublishingThe Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy1411-48012302-81812023-11-0124213714210.24871/2422023137-142841Performance of Spleen Stiffness, Liver Stifness, and their Combination for Predicting Esophageal among Patient with HBV-Related CirrhosisBilly Stinggo Siahaan0Juferdy Kurniawan1Marcellus Simadibrata2Aulia Rizka3Andri Sanityoso4Cleopas Martin Rumende5Andhika Rachman6Hamzah Shatri7Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, JakartaDivision of Hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, JakartaDivision of Gastroenterology Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, JakartaDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, JakartaDivision of Hepatology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, JakartaDivision of Pulmonology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General National HospitalDivision of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, JakartaDivision of Psychosomatic and Palliative Medicine, Department of Internal Medicine Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, JakartaBackground: Liver cirrhosis in Indonesia still become a burden disease, and the etiology is mostly from the hepatitis B virus. Esophageal varices (EV) is the most common complication of portal hypertension in liver cirrhosis. Due to many reasons, esophagogastroduodenoscopy is still not fully suitable for routine surveillance in daily practice. Hence, studies that work in the search for the best non-invasive test are still important for predicting EV. Method: A total of 71 patients with liver cirrhosis due to hepatitis B who had undergone endoscopy, spleen stiffness measurement (SSM), and liver stiffness measurement (LSM), between January–April 2023 were enrolled. Diagnostic applicability was assessed by the area under the receiver-operator curve (AUC) to measure and compare the performance of each measurement and combination for predicting EV and to obtain the corresponding optimal prediction value. Results: This study was participated by 71 subjects with liver cirrhosis. The prevalence of Child-Pugh A was 74.6% (53 patients), Child-Pugh B 22.5% (16 patients), and 2.8% (2 patients) with Child-Pugh C. Among these patients, the proportion of EV was 71.8%. This study showed that SSM with a cut-off of 38.8 kPa had AUC 0.867 (95% CI: 0.774–0.960) (sensitivity 78.4%, specificity 80%) and LSM with a cut-off of 10.55 kPa had AUC 0.822 (95% CI: 0.701–0.943) (sensitivity 88.2%, specificity 65%). Conclusion: Spleen stiffness and liver stiffness measurements have a good performance for predicting EV in patients with liver cirrhosis caused by hepatitis B.https://ina-jghe.com/index.php/jghe/article/view/909liver stiffnessspleen stiffnessesophageal varices
spellingShingle Billy Stinggo Siahaan
Juferdy Kurniawan
Marcellus Simadibrata
Aulia Rizka
Andri Sanityoso
Cleopas Martin Rumende
Andhika Rachman
Hamzah Shatri
Performance of Spleen Stiffness, Liver Stifness, and their Combination for Predicting Esophageal among Patient with HBV-Related Cirrhosis
The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
liver stiffness
spleen stiffness
esophageal varices
title Performance of Spleen Stiffness, Liver Stifness, and their Combination for Predicting Esophageal among Patient with HBV-Related Cirrhosis
title_full Performance of Spleen Stiffness, Liver Stifness, and their Combination for Predicting Esophageal among Patient with HBV-Related Cirrhosis
title_fullStr Performance of Spleen Stiffness, Liver Stifness, and their Combination for Predicting Esophageal among Patient with HBV-Related Cirrhosis
title_full_unstemmed Performance of Spleen Stiffness, Liver Stifness, and their Combination for Predicting Esophageal among Patient with HBV-Related Cirrhosis
title_short Performance of Spleen Stiffness, Liver Stifness, and their Combination for Predicting Esophageal among Patient with HBV-Related Cirrhosis
title_sort performance of spleen stiffness liver stifness and their combination for predicting esophageal among patient with hbv related cirrhosis
topic liver stiffness
spleen stiffness
esophageal varices
url https://ina-jghe.com/index.php/jghe/article/view/909
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