Liver stiffness measurement selects patients with cirrhosis at risk of bearing large oesophageal varices

Background/AimsPeriodic endoscopic screening for oesophageal varices is recommended in patients with cirrhosis, but might be limited to a subgroup of patients if a simple non-invasive test was available to select those at risk of bleeding.MethodsWe studied in 165 patients with cirrhosis the relation between the presence of oesophageal varices assessed by endoscopy, and liver stiffness measurement by Fibroscan®, a non-invasive parameter related to liver fibrosis. The results were compared to those of other parameters reflecting portal hypertension, splenic size, platelet count, and platelet count/spleen size ratio.ResultsLiver stiffness measurement was correlated to the grade of oesophageal varices (r = 0.6, p < 0.0001). AUROC values of liver stiffness measurement were 0.84 (95% CI: 0.78–0.90) for the presence of oesophageal varices and 0.83 (0.76–0.89) for varices grade ⩾ II. Liver stiffness measurement value <19 kPa was highly predictive of the absence of oesophageal varices grade ⩾ II (Se: 84%, PPV: 47%, NPV: 93%).ConclusionsLiver stiffness measurement allows to predict the presence of large oesophageal varices in patients with cirrhosis, and may help to select patients for endoscopic screening.