Title Validation of albumin, bilirubin, and platelet criteria for avoiding screening endoscopy in patients with advanced fibrosis.
Author Tamaki, Nobuharu; Kurosaki, Masayuki; Higuchi, Mayu; Kirino, Sakura; Inada, Kento; Yamashita, Koji; Sekiguchi, Shuhei; Hayakawa, Yuka; Osawa, Leona; Takaura, Kenta; Maeyashiki, Chiaki; Kaneko, Shun; Yasui, Yutaka; Tsuchiya, Kaoru; Nakanishi, Hiroyuki; Itakura, Jun; Izumi, Namiki
Journal Hepatol Res Publication Year/Month 2020-Aug
PMID 32515534 PMCID -N/A-
Affiliation 1.Department of Gastroenterology and Hepatology, Musasino Red Cross Hospital, Tokyo, Japan.

AIM: The albumin, bilirubin, and platelet (ABP) criteria was proposed to avoid screening endoscopy for detecting high-risk varices (HRV) and it has high diagnostic accuracy. We carried out a retrospective cross-sectional study to verify the diagnostic accuracy. METHODS: A total of 610 patients with advanced fibrosis were enrolled in the study. ABP criteria are defined as follows: albumin >4.0 g/dL, bilirubin <22 mumol/L, and platelets >114 000/muL. RESULTS: Background liver disease were hepatitis C/hepatitis B/non-alcoholic fatty liver disease/others:405 (66.4%)/67 (10.5%)/78 (12.8%)/60 (10.3%). A total of 105 patients (17.2%) had HRV. In multivariate analysis, serum bilirubin <22 mumol/L (HR 2.00, 95% CI 1.2-3.4), albumin >4.0 g/dL (HR 2.56, 95% CI 1.7-3.8), and platelets >114 000/muL (HR 3.52, 95% CI 2.1-5.8) levels were independently associated with no presence of HRV. When the ABP criteria were examined, 200 patients (32.8%) fulfilled the criteria, and 194 patients had no HRV (positive predictive value 97.0%) When classified by etiologies (hepatitis C/hepatitis B/non-alcoholic fatty liver disease), positive predictive value were 97.7/100/92.0%, respectively. CONCLUSIONS: The ABP criteria are easy to examine, because they use only standard laboratory tests, and they are available for screening patients who might avoid endoscopy regardless of etiologies.

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