Variceal hemorrhaging is associated with a high mortality rate. The early detection of esophageal varices is critical for the effective prevention of variceal hemorrhage.
In daily medical practice, it is common to encounter patients with liver damage from chronic alcohol consumption. When the alcoholic patient is examined, it is often evident that alcoholic liver damage is progressing. Once alcoholic cirrhosis is established, esophageal varices develop in the majority of patients, as found during prolonged follow-up. Nevertheless, alcoholic patients tend to be indifferent regarding their health, and are not likely to undergo periodic consultations. The research team therefore examined the predictive factors for esophageal varices in severe alcoholic disease.
An article to be published on April 7, 2008 in the World Journal of Gastroenterology describes the predictive factors. A study was reported by Dr. Satoshi Mamori, of Jikei University, in which he analyzed the background of alcoholic patients to predict the occurrence of esophageal varices.
Abdominal ultrasonography (US) was performed on 444 patients suffering from alcoholism. The alcoholic patients with splenomegaly and/or withering of the right lobe of the liver were defined as severe alcoholic disease patients (SAD) and participated as the study subjects. The SAD patients were observed by upper gastrointestinal (UGI) endoscopy to evaluate the development of esophageal varies. The existence of esophageal varices was then compared according to a number of clinical background variables.
44 patients were identified as SAD patients. Twenty-five patients (56.8%) had esophageal varices, and a univariate analysis revealed a significant difference in the age and type IV collagen levels between the patients with and without esophageal varices. Moreover, a logistic regression analysis identified only one independent variable predictive of esophageal varices: type IV collagen (P = 0.017). The area under the curve of type IV collagen, as determined by the receiver operating characteristic for predicting expressed esophageal varices, was 0.78.
The combination of abdominal ultrasound scan and type IV collagen correctly identified, at a high rate, the patients with esophageal varices.
Reference: Mamori S, Searashi Y, Matsushima M, Hashimoto K, Uetake S, Matsudaira H, Ito S, Nakajima H, Tajiri H. Serum type IV collagen is a predictive factor of esophageal varices in patients with severe alcoholic disease. World J Gastroenterol 2008; 14(13): 2044-2048 http://www.wjgnet.com/1007-9327/14/2044.asp
Correspondence to: Satoshi Mamori, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, the Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. mamori@jikei.ac.jp Telephone: +81-3-34331111-3201 Fax: +81-3-3435-0569
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection. It provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the title China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology