Difference between type 2 gastroesophageal varices and isolated fundic varices in clinical profiles and portosystemic collaterals

Table 1 Demographic characteristics and laboratory tests in different groups of enrolled patients

Variables		Total (222)	GOV2 (109)		IGV1 (113)	P value	IGV1 (113)
							Liver cirrhosis (67)	Pancreatic diseases (38)	Others (8)	P value
Gender, n (M/F)		128/94	70/39		58/55	0.052	33/34	22/16	3/5	0.497
Age, yr		53.52 ± 12.20	53.00 ± 11.92		54.03 ± 12.51	0.532	55.61 ± 10.75	50.16 ± 14.74	59.13 ± 11.38	0.047
Peripheral blood routine examination
Erythrocytes (1012/L)	3.32 ± 0.78		3.20 ± 0.73		3.44 ± 0.81	0.022	3.47 ± 0.86	3.33 ± 0.75	3.83 ± 0.62	0.315
Leukocyte (109/L)	3.94 (2.56-5.62)		3.28 (2.00-5.32)		4.42 (3.29-5.86)	0.001	3.85 (2.75-5.52)	5.08 (3.79-7.61)	4.50 (4.27-5.86)	0.034
Platelet (109/L)	87.50 (57.00-148.75)		70.00 (49.00-137.00)		113.00 (73.00-156.00)	0.001	84.00 (59.00-129.00)	147.00 (96.00-181.00)	117.00 (115.00-187.00)	< 0.001
Biochemistry
ALT (U/L)	28.00 (18.00-41.00)		28.00 (20.00-39.25)		27.00 (14.00-44.00)	0.403	34.00 (21.00-48.00)	18.00 (10.00-32.00)	12.00 (7.00-23.00)	< 0.001
AST (U/L)	33.00 (22.00-49.00)		35.00 (24.75-51.00)		31.00 (19.00-47.50)	0.095	41.00 (25.00-62.00)	19.00 (15.00-31.00)	20.00 (12.00-24.00)	< 0.001
ALP (U/L)	84.00 (64.00-126.00)		85.00 (67.75-119.25)		82.00 (59.00-128.00)	0.515	92.00 (62.00-139.00)	71.00 (51.00-113.00)	82.00 (49.00-100.00)	0.163
γGT (U/L)	35.00 (19.00-75.00)		36.50 (20.00-75.00)		33.00 (16.00-78.50)	0.523	46.00 (25.00-84.00)	21.00 (11.00-60.00)	19.00 (8.00-23.00)	0.001
T-Bil (µmol/L)	18.20 (13.00-26.00)		19.70 (14.83-29.45)		16.70 (10.65-24.05)	0.003	18.00 (13.00-26.70)	13.90 (9.80-19.40)	12.50 (10.20-16.70)	0.045
Albumin (g/L)	34.73 ± 6.43		33.54 ± 5.87		35.93 ± 6.77	0.007	34.64 ± 7.06	37.54 ± 5.87	39.40 ± 6.09	0.046
INR	1.22 (1.10-1.38)		1.27 (1.14-1.44)		1.18 (1.06-1.31)	0.001	1.22 (1.08-1.39)	1.12 (1.04-1.20)	1.04 (0.99-1.43)	0.021
Cholesterol	3.37 (2.68-4.15)		3.14 (2.54-4.04)		3.64 (2.82-4.35)	0.036	3.55 (2.82-4.27)	3.75 (2.96-4.77)	3.43 (2.30-7.95)	0.607
Child-Pugh classification (A/B/C)	113/70/4		48/49/1		65/21/3	< 0.001	35/14/3	26/7/0	4/0/0	0.467
MELD	10.00 (8.00-11.00)		10.00 (8.00-12.50)		9.00 (7.00-11.00)	0.006	10.00 (8.00-11.00)	8.00 (7.00-9.00)	7.00 (6.50-10.00)	0.007
Endoscopic findings
Portal hypertensive gastropathy	28/222 (12.61%)			24/109 (22.02%)	4/113 (3.54%)	< 0.001	4/67 (5.97%)	0	0		/
Peptic ulcer	42/222 (18.92%)			12/109 (11.01%)	30/113 (26.55%)	0.003	26/67 (38.81%)	4/38 (10.53%)	0		0.001

Note: Continuous variables were presented as median (25th–75th percentiles) (skewed distribution) or mean ± SD (Gaussian distribution), and categorical variables are presented as count (percentage). Normal ranges: Erythrocytes: 4.3 × 10¹²/L-5.8 × 10¹²/L; Leukocyte: 3.5 × 10⁹/L-9.5 × 10⁹/L; Platelet: 125 × 10⁹/L-350 × 10⁹/L; Alanine aminotransferase: 5-40 U/L; Aspartate aminotransferase: 8-40 U/L; Alkaline phosphatase: 40-150 U/L; γ-glutamyl transpeptidase: 11-50 U/L; total bilirubin: 5.1-19.0 μmol/L; Albumin: 35-55 g/L; International normalized ratio: 0.80-1.31; cholesterol: < 5.2 mmol/L. GOV2: Gastroesophageal varices; IGV1: Isolated gastric varices; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; γ-GT: γ-glutamyl transpeptidase; T-BIL: Total bilirubin; INR: International normalized ratio.

Table 2 Radiological findings and portosystemic collateral vessels in patients with gastric fundic varices

Variables	Total (179)	GOV2 (97)	IGV1 (82)	P value	IGV1 (82)
					Liver cirrhosis (50)	Pancreatic diseases (27)	Others (5)	P value
Gallbladder wall thickening1	69/164 (42.07%)	51/92 (55.43%)	18/72 (25.00%)	< 0.001	10/46 (21.74%)	7/21 (33.33%)	1/5 (20.00%)	0.678
The longest dimension of spleen (cm)	14.06 (12.44-15.93)	15.74 ± 2.97	13.30 ± 2.25	< 0.001	13.50 ± 2.30	12.90 ± 1.62	13.55 ± 4.91	0.529
Ascites	80/179 (44.69%)	61/97 (62.89%)	19/82 (23.17%)	< 0.001	13/50 (26.00%)	6/27 (22.22%)	0	0.583
Portal vein thrombosis	34/179 (18.99%)	30/97 (30.93%)	4/82 (4.88%)	< 0.001	2/50 (4.00%)	2/27 (7.41%)	0	0.697
Cavernous transformation of portal vein	21/179 (11.73%)	18/97 (18.56%)	3/82 (3.66%)	< 0.001	1/50 (2.00%)	2/27 (7.41%)	0	0.405
The volume of gastric varices (mL)	3.35 (1.62-8.55)	2.39 (1.35-4.81)	5.60 (2.35-15.68)	< 0.001	10.00 (3.14-21.50)	4.12 (2.72-6.35)	1.24 (0.63-8.17)	0.005
The diameter of main portal vein (mm)	14.71 (12.19-16.59)	15.17 (13.44-17.21)	13.65 ± 2.76	< 0.001	13.08 ± 2.40	14.38 ± 3.21	15.14 ± 2.29	0.066
The diameter of splenic vein (mm)	10.14 (8.21-12.38)	11.00 (9.17-13.61)	9.08 ± 2.43	< 0.001	8.92 (7.19-10.67)	8.14 (5.18-10.95)	9.98 (9.42-12.37)	0.312
The diameter of superior mesenteric vein (mm)	11.78 (10.09-13.44)	12.63 (10.77-13.90)	11.06 ± 2.11	< 0.001	11.00 ± 2.02	11.23 ± 2.16	10.73 ± 3.07	0.845
Afferent veins of gastric varices
Left gastric vein	157/179 (87.71%)	95/97 (97.94%)	62/82 (75.61%)	< 0.001	39/50 (78.00%)	21/27 (77.78%)	2/5 (40.00%)	0.194
Short gastric vein	90/179 (50.28%)	38/97 (39.18%)	52/82 (63.41%)	0.001	30/50 (60.00%)	22/27 (81.48%)	0	0.002
Posterior gastric vein	60/179 (33.52%)	24/97 (24.74%)	36/82 (43.90%)	0.007	25/50 (50.00%)	9/27 (33.33%)	2/5 (40.00%)	0.381
Efferent veins of gastric varices
Splenorenal shunt	20/179 (11.17%)	11/97 (11.34%)	9/82 (10.98%)	0.939	7/50 (14.00%)	1/27 (3.70%)	1/5 (20.00%)	0.212
Gastrorenal shunt	65/179 (36.31%)	21/97 (21.65%)	44/82 (53.66%)	< 0.001	39/50 (78.00%)	4/27 (14.81%)	1/5 (20.00%)	< 0.001
Other portosystemic collateral vessels
Spleno-gastroomental-superior mesenteric shunt	17/179 (9.50%)	1/97 (1.03%)	16/82 (19.51%)	< 0.001	3/50 (6.00%)	13/27 (48.15%)	0	< 0.001
Paraumbilical vein patency	44/179 (24.58%)	37/97 (38.14%)	7/82 (8.54%)	< 0.001	7/50 (14.00%)	0	0	/
Intrahepatic portosystemic shunts	7/179 (3.91%)	4/97 (4.12%)	3/82 (3.66%)	1.000	3/50 (6.00%)	0	0	/
Retroperitoneal shunt	52/179 (29.05%)	37/97 (38.14%)	15/82 (18.29%)	0.004	6/50 (12.00%)	8/27 (29.63%)	1/5 (20.00%)	0.131

¹Indicated 15 of patients with fundic varices had received cholecystectomy.

GOV2: Gastroesophageal varices; IGV1: Isolated gastric varices.

Table 3 The correlations between afferent/efferent veins and portosystemic collaterals in patients with gastroesophageal varices

Variables		The volume of varices (mL)		The diameter of main portal vein (mm)	Afferent veins			Efferent veins		Other portosystemic collateral vessels
		The volume of EVs (mL)	The volume of GVs (mL)		Maximum diameter of LGV (mm)	Maximum diameter of PGV (mm)	Maximum diameter of SGV (mm)	Maximum diameter of SRS (mm)	Maximum diameter of GRS (mm)	Intrahepatic portosystemic shunts	Paraumbilical vein patency	Retroperitoneal shunt
Maximum diameter of LGV (mm)	Correlation coefficient	0.411	0.372	0.052	/	0.099	0.307	-0.374	-0.018	0.061	0.081	-0.039
	P value	0.000	0.000	0.632	/	0.654	0.061	0.258	0.940	0.556	0.437	0.711
	n	92	90	88	/	23	38	11	20	95	95	95
Short gastric vein	Correlation coefficient	0.139	0.066	0.013	0.132	-0.038	/	-0.179	0.268	0.046	0.022	0.065
	P value	0.182	0.532	0.903	0.204	0.859	/	0.598	0.241	0.655	0.831	0.524
	n	94	92	90	95	24	38	11	21	97	97	97
Posterior gastric vein	Correlation coefficient	-0.055	0.378	-0.239	0.199	/	0.100	0.298	0.520	0.121	-0.106	0.091
	P value	0.600	0.000	0.023	0.053	/	0.550	0.373	0.016	0.236	0.302	0.377
	n	94	92	90	95	24	38	11	21	97	97	97
Maximum diameter of splenorenal shunt (mm)	Correlation coefficient	0.200	-0.155	-0.533	-0.374	1.000	0.000	/	/	/	-0.418	0.000
	P value	0.580	0.650	0.139	0.258	/	1.000	/	/	/	0.200	1.000
	n	10	11	9	11	2	7	/	1	11	11	11
Maximum diameter of gastrorenal shunt (mm)	Correlation coefficient	-0.518	0.755	-0.434	-0.018	0.745	0.576	/	/	0.332	-0.113	-0.238
	P value	0.023	0.000	0.072	0.940	0.013	0.082	/	/	0.141	0.625	0.298
	n	19	20	18	20	10	10	1	/	21	21	21

The correlations of categorical or continuous variables were analyzed by Spearman correlation test. In determining the maximum diameter of a vessel, isolated saccular dilatation of a vessel in venous ectasia or venous aneurysm was excluded. EVs: Esophageal varices; GVs: Gastric varices; LGV: Left gastric vein; PGV: Posterior gastric vein; SGV: Short gastric vein; SRS: Splenorenal shunt; GRS: Gastrorenal shunt.

Table 4 The correlations between afferent/efferent veins and portosystemic collaterals in patients with isolated gastric varices

Variables		The volume of gastric varices (mL)	The diameter of main portal vein (mm)	Afferent veins			Efferent veins			Other portosystemic collateral vessels
				Maximum diameter of LGV (mm)	Maximum diameter of SGV (mm)	Maximum diameter of PGV) (mm)	Maximum diameter of splenorenal shunt (mm)	Maximum diameter of gastrorenal shunt (mm)	Spleno-gastroomental-superior mesenteric shunt	Intrahepatic portosystemic shunts	Paraumbilical vein patency	Retroperitoneal shunt
Maximum diameter of LGV (mm)	Correlation coefficient	0.405	0.241	/	0.167	0.143	0.543	0.366	0.259	-0.211	-0.121	0.153
	P value	0.001	0.065	/	0.291	0.506	0.266	0.036	0.042	0.100	0.350	0.236
	n	59	59	/	42	24	6	33	62	62	62	62
Maximum diameter of SGV (mm)	Correlation coefficient	0.212	0.113	0.167	/	0.328	-0.600	0.421	0.223	0.007	-0.014	0.083
	P value	0.135	0.432	0.291	/	0.215	0.285	0.026	0.111	0.963	0.919	0.559
	n	51	51	42	/	16	5	28	52	52	52	52
Posterior gastric vein	Correlation coefficient	0.047	0.007	0.257	-0.317	/	0.548	-0.091	-0.064	0.220	0.082	0.090
	P value	0.682	0.949	0.044	0.022	/	0.127	0.555	0.571	0.047	0.467	0.422
	n	78	79	62	52	36	9	44	82	82	82	82
Maximum diameter of PGV (mm)	Correlation coefficient	0.667	0.012	0.143	0.328	/	1.000	0.506	0.093	-0.053	-0.111	-0.315
	P value	0.000	0.946	0.506	0.215	/	0.000	0.014	0.588	0.758	0.521	0.061
	n	34	33	24	16	/	3	23	36	36	36	36
Splenorenal shunt	Correlation coefficient	0.175	-0.008	0.093	-0.128	0.102	/	-0.131	0.024	-0.068	0.172	0.036
	P value	0.126	0.945	0.472	0.365	0.555	/	0.395	0.830	0.541	0.122	0.750
	n	78	79	62	52	36	9	44	82	82	82	82
Maximum diameter of Splenorenal shunt (mm)	Correlation coefficient	0.667	-0.083	0.543	-0.600	1.000	/	-0.500	-0.621	/	0.104	-0.414
	P value	0.071	0.831	0.266	0.285	0.000	/	0.667	0.074	/	0.791	0.268
	n	8	9	6	5	3	/	3	9	9	9	9
Gastrorenal shunt	Correlation coefficient	0.173	-0.245	-0.123	-0.148	-0.062	-0.456	/	-0.419	0.177	0.102	-0.141
	P value	0.129	0.029	0.340	0.296	0.718	0.217	/	0.000	0.112	0.364	0.205
	n	78	79	62	52	36	9	44	82	82	82	82
Maximum diameter of gastrorenal shunt (mm)	Correlation coefficient	0.735	-0.242	0.366	0.421	0.506	-0.500	/	0.043	0.018	0.149	-0.037
	P value	0.000	0.123	0.036	0.026	0.014	0.667	/	0.782	0.909	0.333	0.814
	n	44	42	33	28	23	3	/	44	44	44	44
Spleno-gastroomental-superior mesenteric shunt	Correlation coefficient	-0.025	0.314	0.259	0.223	0.093	-0.621	0.043	/	-0.096	-0.150	0.245
	P value	0.826	0.005	0.042	0.111	0.588	0.074	0.782	/	0.391	0.177	0.027
	n	78	79	62	52	36	9	44	/	82	82	82

The correlation of categorical or continuous variables was analyzed by Spearman correlation test. In determining the maximum diameter of a vessel, isolated saccular dilatation of a vessel in venous ectasia or venous aneurysm was excluded. LGV: Left gastric vein; SGV: Short gastric veins; PGV: Posterior gastric vein.