Evaluation of Vitro Score (Von Willebrand Factor Antigen/Thrombocyte Ratio) as a New Marker for Presence of Esophageal Varices due to Clinically Significant Portal Hypertension (CSPH) in Liver Cirrhosis

Abstract Background Bleeding due to esophageal varices is one of the causes of high mortality in cirrhotic patients. Esophageal varices occurs with the presence of clinically significant portal hypertension that is more than 10 mmHg. The most diagnostic method for clinically significant portal hypertension is the measurement of HVPG and the most diagnostic to detect esophageal varices is UGIE, both of which are invasive procedures and costly. Aim of the Work to evaluqate the vitro score as a non-invasive marker for presence of esophageal varices in clinically significant portal hypertension. Patients and Methods The study was carried out on 60 Egyptian patients. These were divided into two groups (varices and no varices) based on the findings of UGIE. For all participant in this study, full clinical assessment by history and physical examination was done in addition to laboratory hematological and biochemical assessment and detection of varices was done by UGIE, We also assessed serum vWF antigen in all study participant. Results In this study, we found the VITRO score was higher in patients with esophageal varices. We found that the VITRO score ranged from 0.78 to 1.92 in patients with varices with median (IQR) 1.22(1.03-1.32); and from 0.08 to 0.82 in patients with no cirrhosis with median(IQR) 0.23 (0.15-0.4), being statistically significant higher in patients with varices with p-value= 0. There was no significant correlation between VITRO score and (age, WBCs, HB, BUN, Creat, Na, K, Total and direct bilirubin, AST, ALT, AFP and MELD score). The results showed sensitivity 93.75% and specificity 100% for VITRO score as a marker for detection of esophageal varices, with cut-off point > 0.82 Conclusion VITRO score is a promising non-invasive marker for detection of esophageal varices.