Predictive value of liver fibrosis markers and model for end-stage liver disease score in evaluating the degree of esophageal and gastric varices in cirrhosis.

OBJECTIVE

We aimed to investigate the predictive value of liver fibrosis (LF) markers and the Model for End-Stage Liver Disease (MELD) score in assessing the severity of esophageal and gastric varices (EGV) in patients with liver cirrhosis (LC).

METHODS

This retrospective study included 136 LC patients categorized by EGV severity into no EGV, mild EGV, moderate EGV, and severe EGV groups. Ordered multinomial logistic regression was used to identify independent risk factors, and multinomial ROC curves assessed the diagnostic performance of individual markers and combined models.

RESULTS

Hyaluronic acid (HA, r=0.867), laminin (LN, r=0.892), type IV collagen (CIV, r=0.885), type III procollagen N-terminal peptide (PIIINP, r=0.879), liver fibrosis 4 factor index (FIB-4, r=0.793), and MELD score (r=0.825) showed strong positive correlations with EGV severity (all P<0.01). After adjusting for confounding factors, including cirrhosis etiology, ascites, and hepatic encephalopathy, all these markers remained independent predictors of EGV severity. The combined model (HA+LN+CIV+PIIINP+FIB-4+MELD) demonstrated optimal diagnostic performance with an AUC of 0.89 (95% CI: 0.84-0.94), sensitivity of 83.6%, specificity of 81.2%, positive predictive value of 79.5%, and negative predictive value of 85.1%.

CONCLUSION

The combined use of liver fibrosis markers and MELD score enables precise assessment of EGV severity in LC patients, providing a reliable non-invasive evaluation tool for clinical practice.