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Evaluation the value of markers for prediction of portal vein thrombosis after devascularization
Yang Fei1, Guang-quan Zong1, Jian Chen1
1Department of General Surgery, the 81st Hospital of P.L.A. Nanjing, JiangSu, China.
Insights
D-dimer and P-selectin levels can predict portal vein thrombosis (PVT) in cirrhotic portal hypertension (PHT) patients after devascularization. Combining these markers enhances predictive accuracy for PVT.
Area of Science:
- Hepatology
- Vascular Surgery
- Diagnostic Biomarkers
Background:
- Cirrhotic portal hypertension (PHT) poses risks for portal vein thrombosis (PVT).
- Devascularization surgery in PHT patients requires effective methods for PVT prediction.
- Early detection of PVT is crucial for patient management.
Purpose of the Study:
- To assess the predictive value of D-dimer and P-selectin for PVT in cirrhotic PHT patients post-devascularization.
- To compare the diagnostic performance of D-dimer and P-selectin individually and in combination.
Main Methods:
- Retrospective review of 137 cirrhotic PHT patients undergoing devascularization.
- Division into PVT and non-PVT groups based on Doppler ultrasonography.
- Peri-operative measurement of D-dimer and P-selectin levels.
Main Results:
- PVT occurred in 27.7% of patients.
- Elevated D-dimer and P-selectin levels were significantly higher in the PVT group post-operatively (P < 0.05).
- Combined D-dimer and P-selectin testing improved PVT prediction sensitivity to 0.911 and AUC to 0.919.
Conclusions:
- D-dimer and P-selectin show potential as predictive markers for PVT in cirrhotic PHT patients after devascularization.
- The combined use of D-dimer and P-selectin enhances diagnostic accuracy for PVT.
- These biomarkers may aid in early identification and management of PVT in this patient cohort.
Aim:
To evaluate the value of D-dimer and P-selectin in cirrhotic portal hypertension (PHT) patients for prediction of portal vein thrombosis (PVT) after devascularization.
Material And Methods:
137 patients with cirrhotic PHT who undergone devascularization from January 2012 to April 2014 were retrospectively reviewed, all of them were divided into two groups (PVT group and non-PVT group) by Doppler ultrasonography (DU) examination. The level of D-dimer and P-selectin was tested during the peri-operative period.
Results:
38 patients (27.7%) were found PVT by DU examination post-operatively. In contrast to the non- PVT group, the level of D-dimer and P-selectin in the PVT group was much higher significantly at 1, 3 and 7 days after devascularization (P < 0.05). However, in the 15 days after surgery, the difference of P-selectin between the two groups was not significant (P = 0.260). It was shown that the higher sensitivity of the two markers for PVT was D-dimer, the higher specificity belonged to P-selectin. The area under receiver operating characteristic (ROC) curve of P-selectin was the bigger of the two markers. When the two markers were combined to be used to diagnose PVT, the sensitivity was increased to 0.911, with a slight drop of specificity to 0.715, the area under ROC curve was 0.919.
Conclusion:
The level of D-dimer and P-selectin might be good candidate predictive markers for PVT in patients with cirrhotic PHT after devascularization. The combined test of the two markers can increase the value of prediction.
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