الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Background: The gold standard screening technique for presence of esophageal varices and its risk for bleeding is upper GI endoscopy. The development of a non-invasive method for early prediction of esophageal varices and its risk of bleeding would identify high-risk patients with lesser need for expensive, risky and invasive endoscopy. VEGF is known as an important angiogenic factor and has a crucial role in portal hypertension and collateral vessels formation. Objectives: Assessment of urinary VEGF level in cirrhotic patients as a predictor of presence and severity of esophageal varices. Methods: 42 cirrhotic patients were randomly selected and classified into 2 groups according to the presence or absence of variceal bleeding. VEGF was measured in urine of both groups and compared to 42 healthy controls. VEGF level was corrected against urinary creatinine. Platelet count, liver function tests, abdominal ultrasonography and upper GI endoscopy were done to all patients. The association between urinary VEGF and all previous parameters as well as with clinical data was sought. Results: Significantly lower levels of urinary VEGF were detected in cirrhotic patients with esophageal varices than those without, and both groups were lower than that of controls. By multivariable logistic regression, low VEGF, low platelet count and splenomegaly were found to be independent predictors of both the presence of large esophageal varices, and variceal bleeding. Receiver operating characteristic (ROC) curve analysis showed that platelet count{u2264} 166.3x10 ³/ æL, and corrected VEGF{u2264}59.12 pg/mg were predictive of large esophageal varices with 93.1%, 86.2% sensitivity and 74.5%, 58.2% specificity respectively