Version 1
: Received: 27 September 2023 / Approved: 29 September 2023 / Online: 30 September 2023 (10:08:10 CEST)
How to cite:
Tarantino, G.; Citro, V.; Tarantino, M.; Capone, D. Diagnosing Liver Cirrhosis by Overlooked Tools: A Retrospective Study. Preprints2023, 2023092059. https://doi.org/10.20944/preprints202309.2059.v1
Tarantino, G.; Citro, V.; Tarantino, M.; Capone, D. Diagnosing Liver Cirrhosis by Overlooked Tools: A Retrospective Study. Preprints 2023, 2023092059. https://doi.org/10.20944/preprints202309.2059.v1
Tarantino, G.; Citro, V.; Tarantino, M.; Capone, D. Diagnosing Liver Cirrhosis by Overlooked Tools: A Retrospective Study. Preprints2023, 2023092059. https://doi.org/10.20944/preprints202309.2059.v1
APA Style
Tarantino, G., Citro, V., Tarantino, M., & Capone, D. (2023). Diagnosing Liver Cirrhosis by Overlooked Tools: A Retrospective Study. Preprints. https://doi.org/10.20944/preprints202309.2059.v1
Chicago/Turabian Style
Tarantino, G., Marianna Tarantino and Domenico Capone. 2023 "Diagnosing Liver Cirrhosis by Overlooked Tools: A Retrospective Study" Preprints. https://doi.org/10.20944/preprints202309.2059.v1
Abstract
Background
Total serum bile acids (TSBA), liver-spleen scan and dynamic liver functional tests, in our case the antipyrine clearance (Ap Cl), have been long adopted. The aim of our study was that of assessing whether some diagnostic tests, scarcely performed due to the novel techniques implementation, were reliable diagnostic tools.
Methods
Data extracted from records of two well-matched for age and gender populations was retrospectively analysed. Specifically, 17 patients with biopsy-proven chronic hepatitis were confronted with 17 subjects suffering from liver cirrhosis. Clinical, laboratory and instrumental findings, such as the Child-Pugh classification, the number connection test for evaluating hepatic encephalopathy, prothrombin time, serum albumin levels, TSBA concentration, Ap Cl determination, abdominal ultrasound and liver-spleen scan imaging as well as endoscopy features were evaluated.
Results
Cirrhotics showed a median concentration of TSBA increased respect to that of patients with chronic hepatitis, independently from gender, 20.1 versus 12.24 micromol/L, P= 0.0054. The median AP Cl value of the patients with liver cirrhosis was reduced confronted with that of patients with chronic hepatitis, specifically, 13.92 opposed to 18.3 mcg Ap/dL, P= 0.045. Furthermore, the median liver-spleen scan score was higher in cirrhotics than in chronic hepatitis patients, i.e., 3.47 versus 1.47, P= 0.000. The AUROCs of TSBA levels and of the liver-spleen scan scores for differentiating patients with liver cirrhosis from those with chronic hepatitis were 0.82 and 0.96, respectively. When was applied a new predictive model, combining the previous ones, the AUROC to discriminate patients belonging to the two populations was 0.98. The best cut-off of the new index was 26, with a sensitivity and specificity of 100.00% and 82.35%, respectively, correctly classifying 91.18% of the patients.
Discussion
Both TSBA and liver-spleen scan were high discriminant as well as their combination, while Ap Cl showed some limitations as reliable diagnostic tool. TSBA and liver-spleen scan have been too soon and unnecessarily overlooked.
Keywords
Total serum bile acids; antipyrine clearance; liver-spleen scan; chronic hepatitis; liver cirrhosis; AUROCs
Subject
Medicine and Pharmacology, Gastroenterology and Hepatology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
