Prognostic factors in non-malignant and non-cirrhotic patients with portal cavernoma: An 8-year retrospective single-center study

doi:10.3748/wjg.v19.i42.7447

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World Journal of Gastroenterology

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World J Gastroenterol. Nov 14, 2013; 19(42): 7447-7454
Published online Nov 14, 2013. doi: 10.3748/wjg.v19.i42.7447

Table 1 Patient characteristics at admission

Sex (female/male )	26/38
Age at admission (yr)	32.05 ± 2.00
Age at first diagnosis of portal cavernoma ( ≤ 18 yr/> 18 yr)	26/38
History of portal cavernoma (yr)	3.68 ± 0.78
Clinical presentations
Abdominal distension	37
Abdominal pain	26
Variceal bleeding	29
Degree of varices (high risk/low risk/no varices)	6/12/1946
Ascites	20
Degree of ascites (grade III/grade II/grade I/no ascites)	3/1/16/44
Hydrothorax	10
Laboratory tests
RBC (10¹²/L)	3.95 ± 0.11
Hb (g/L)	106.25 ± 4.00
WBC (10⁹/L)	8.11 ± 1.03
PLT (10⁹/L)	298.73 ± 33.67
PT (s)	14.14 ± 0.24
INR	1.15 ± 0.02
ALT (U/L )	29.97 ± 3.31
AST (U/L)	30.28 ± 2.64
ALP (U/L)	107.21 ± 7.68
GGT (U/L)	41.16 ± 5.96
ALB (g/L)	38.25 ± 0.58
TBIL (μmol/L)	16.05 ± 1.32
Serum Cr (μmol/L)	70.65 ± 2.48
Serum Na (mmol/L)	139.54 ± 0.45
Child-Pugh class (A/B/C)	12/1/1951
Child-Pugh score	5.70 ± 0.13
MELD score	4.25 ± 0.53
Location and degree of obstruction
Main portal vein (patent/partial/complete/fibrotic cord)	5/5/12/42
Right portal vein obstruction	49
Left portal vein obstruction	51
Splenic vein obstruction and splenectomy	39
Superior mesenteric vein obstruction	34

Data are expressed as quantitative data as frequency or mean ± SE. RBC: Red blood cell; Hb: Hemoglobin; WBC: White blood cell; PLT: Platelets; PT: Prothrombin time; INR: International normalized ratio; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: γ-glutamyl transferase; ALB: Albumin; TBIL: Total bilirubin.

Table 2 Clinical profile in patients with and without variceal bleeding

Variables	Variceal bleeding (n= 29)	No variceal bleeding (n= 35)	Pvalue
Age at admission (yr)	25.41 ± 2.74	37.54 ± 2.56	0.002
Sex (female/male)	14/15	12/23	0.257
History of portal cavernoma (yr)	5.89 ± 1.44	1.86 ± 0.66	0.009
Abdominal distension (yes/no)	11/18	26/9	0.003
Abdominal pain (yes/no)	3/26	23/12	< 0.001
Ascites (yes/no)	8/21	12/23	0.565
Hydrothorax (yes/no)	4/25	6/29	0.713
Jaundice (yes/no)	2/27	2/33	0.846
RBC (10¹²/L)	3.36 ± 0.12	4.44 ± 0.12	< 0.001
Hb (g/L)	87.21 ± 4.60	122.03 ± 4.86	< 0.001
WBC (10⁹/L)	7.47 ± 1.82	8.65 ± 1.16	0.574
PLT (10⁹/L)	317.07 ± 50.27	283.53 ± 45.84	0.624
PT (s)	14.08 ± 0.35	14.18 ± 0.34	0.838
INR	1.15 ± 0.03	1.15 ± 0.03	0.946
ALT (U/L )	26.38 ± 4.87	32.94 ± 4.51	0.327
AST (U/L )	28.85 ± 4.28	30.93 ± 3.33	0.388
AST/ALT	1.23 ± 0.08	1.21 ± 0.11	0.874
ALP (U/L )	115.98 ± 13.43	99.94 ± 8.57	0.302
GGT (U/L )	31.69 ± 8.60	49.00 ± 8.12	0.150
ALB (g/L )	37.23 ± 0.79	39.09 ± 0.82	0.111
TBIL (μmol/L)	15.54 ± 2.13	16.48 ± 1.66	0.724
DBIL (μmol/L)	7.07 ± 1.54	7.43 ± 0.98	0.838
Serum Cr (μmol/L)	70.17 ± 3.88	71.06 ± 3.26	0.860
Serum Na (mmol/L)	139.26 ± 0.55	139.77 ± 0.70	0.577
Child-Pugh class (A/B/C)	23/5/1	28/7/0	0.529
Child-Pugh score	5.69 ± 0.21	5.71 ± 0.18	0.928
MELD score	3.93 ± 0.88	4.51 ± 0.65	0.593
Main portal vein (fibrotic cord/complete obstruction/partial obstruction/patency)	27/0/1/1	15/12/3/4	< 0.001
Right portal vein (obstruction/patency)	19/10	30/5	0.058
Left portal vein (obstruction/patency)	21/8	30/5	0.188
Splenic vein (obstruction and splenectomy/patency)	14/15	25/10	0.059
Superior mesenteric vein (obstruction/patency)	11/18	23/12	0.027

Table 3 Clinical profile in the patients with and without ascites

Variables	Ascites (n= 20)	No ascites (n= 44)	Pvalue
Age at admission (yr)	36.60 ± 3.99	29.98 ± 2.25	0.127
Sex (female/male)	7/13	19/25	0.537
History of portal cavernoma (yr)	2.38 ± 0.89	4.28 ± 1.06	0.264
Variceal bleeding (yes/no)	12/8	21/23	0.565
Varices (high risk/low risk/no varices)	32/3/9	14/3/3	0.545
Abdominal distension (yes/no)	17/3	20/24	0.003
Abdominal pain (yes/no)	9/11	17/27	0.631
Hydrothorax (yes/no)	10/10	0/44	< 0.001
Jaundice (yes/no)	2/18	2/42	0.403
RBC (10¹²/L)	3.94 ± 0.21	3.96 ± 0.13	0.944
Hb (g/L)	104.60 ± 6.55	107.00 ± 5.04	0.783
WBC (10⁹/L)	12.28 ± 2.83	6.22 ± 0.62	0.006
PLT (10⁹/L)	275.45 ± 53.28	309.30 ± 42.86	0.645
PT (s)	15.08 ± 0.41	13.71 ± 0.28	0.007
INR	1.23 ± 0.03	1.11 ± 0.02	0.006
ALT (U/L)	24.65 ± 3.36	32.39 ± 4.54	0.282
AST (U/L)	28.85 ± 4.28	30.93 ± 3.33	0.717
AST/ALT	1.33 ± 0.18	1.17 ± 0.07	0.305
ALP (U/L)	103.55 ± 10.29	108.88 ± 10.21	0.751
GGT (U/L)	46.70 ± 10.00	38.64 ± 7.43	0.535
ALB (g/L)	35.17 ± 0.91	39.65 ± 0.64	< 0.001
TBIL (μmol/L)	17.79 ± 2.92	15.27 ± 1.39	0.379
DBIL (μmol/L)	8.35 ± 1.57	6.78 ± 1.05	0.409
Serum Cr (μmol/L)	73.40 ± 5.16	69.40 ± 2.77	0.460
Serum Na (mmol/L)	138.01 ± 1.00	140.24 ± 0.45	0.021
Child-Pugh class (A/B/C)	8/11/1	43/1/0	< 0.001
Child-Pugh score	6.85 ± 0.26	5.18 ± 0.07	< 0.001
MELD score	5.60 ± 0.93	3.64 ± 0.63	0.086
Main portal vein (obstruction/patency)	18/2	40/3	0.908
Right portal vein (obstruction/patency)	15/5	34/10	0.842
Left portal vein (obstruction/patency)	16/4	35/9	0.967
Splenic vein (obstruction and splenectomy/patency)	11/9	28/16	0.512
Superior mesenteric vein (obstruction/patency)	15/5	19/25	0.018

Table 4 Univariate analysis of baseline variables predicting overall survival

Variables	HR	95%CI	Pvalue
Sex (female/male)	0.559	0.108-2.883	0.487
Age at admission	1.032	0.984-1.083	0.194
Age at first diagnosis ( ≤ 18 yr/> 18 yr)	0.840	0.187-3.772	0.820
History of portal cavernoma	0.989	0.878-1.114	0.857
Varices (yes/no)	0.428	0.083-2.213	0.311
Variceal bleeding (yes/no)	2.450	0.475-12.653	0.285
Abdominal distension (yes/no)	2.253	0.435-11.657	0.333
Abdominal pain (yes/no)	2.010	0.450-8.989	0.361
Ascites (yes/no)	15.066	1.811-125.337	0.012
Hydrothorax (yes/no)	6.638	1.452-30.346	0.015
RBC	0.681	0.288-1.614	0.383
Hb	0.987	0.964-1.011	0.302
PLT	1.000	0.997-1.003	0.900
WBC	1.099	1.040-1.162	0.001
PT	1.083	0.751-1.562	0.668
INR	5.253	0.057-480.003	0.471
ALT	0.970	0.915-1.029	0.312
AST	0.966	0.905-1.032	0.305
AST/ALT	2.328	0.891-6.083	0.085
ALP	1.003	0.993-1.013	0.558
GGT	1.003	0.989-1.017	0.684
ALB	0.932	0.795-1.094	0.392
TBIL	1.028	0.969-1.091	0.358
DBIL	1.036	0.941-1.140	0.470
Serum Cr	1.007	0.971-1.045	0.704
Serum Na	0.764	0.635-0.918	0.004
Child-Pugh score	1.573	0.976-2.535	0.063
Child-Pugh class (class A/class B and C)	0.083	0.009-0.763	0.028
MELD score	1.067	0.899-1.267	0.459
TIPS insertion (failure/success)	0.677	0.095-4.806	0.696
Main portal vein (patency/obstruction)	0.042	0.0001-1720.16	0.558
Main portal vein (no fibrotic cord/fibrotic cord)	0.798	0.155-4.113	0.787
Right portal vein (patency/obstruction)	2.269	0.507-10.151	0.284
Left portal vein (patency/obstruction)	1.639	0.318-8.455	0.555
Splenic vein (patency/obstruction and splenectomy)	0.533	0.103-2.766	0.454
Superior mesenteric vein (patency/obstruction)	0.159	0.019-1.330	0.090

RBC: Red blood cell; Hb: Hemoglobin; WBC: White blood cell; PLT: Platelets; PT: Prothrombin time; INR: International normalized ratio; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: γ-glutamyl transferase; ALB: Albumin; TBIL: Total bilirubin; DBIL: Direct bilirubin; MELD: Model for end-stage liver disease; TIPS: Transjugular intrahepatic portosystemic shunt.

Citation: Qi XS, Bai M, He CY, Yin ZX, Guo WG, Niu J, Wu FF, Han GH. Prognostic factors in non-malignant and non-cirrhotic patients with portal cavernoma: An 8-year retrospective single-center study. World J Gastroenterol 2013; 19(42): 7447-7454
URL: https://www.wjgnet.com/1007-9327/full/v19/i42/7447.htm
DOI: https://dx.doi.org/10.3748/wjg.v19.i42.7447