ArticleCancer imaging : the official publication of the International Cancer Imaging Society2024
HCC portal hypertension imaging score derived from CT predicts re-bleeding and mortality after acute variceal bleeding.
Article in Cancer imaging : the official publication of the International Cancer Imaging Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 2 citations in OpenAlex.
- Development and validation of a score model for predicting the risk of first esophagogastric variceal hemorrhage and mortality in patients with hepatocellular carcinoma.Annals of medicine · 2025Article
- Artificial intelligence algorithm was used to establish and verify the prediction model of portal hypertension in hepatocellular carcinoma based on clinical parameters and imaging features.Journal of gastrointestinal oncology · 2025Article
- Extracellular vesicles and microRNAs in metabolic dysfunction-associated steatotic liver disease: from steatosis to hepatocellular carcinoma.EXCLI journal · 2025Article
- Comprehensive approach to esophageal variceal bleeding: From prevention to treatment.World journal of gastroenterology · 2024Article
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13 authors at 1 institution in 1 country.
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Abstract
background/purposeRisk factors for re-bleeding and death after acute variceal bleeding (AVB) in cirrhotic HCC patients are not fully understood.We aimed to (1) explore how the combination of high-risk esophageal varices, HCC status, and portal vein tumor thrombus (i.e., HCC Portal Hypertension Imaging Score [HCCPHTIS]) helps predict increased risk of variceal re-bleeding and mortality; (2) assess predictability and reproducibility of the identified variceal re-bleeding rules.
methodsThis prospective study included 195 HCC patients with first-time AVB and liver cirrhosis, and conducted multivariable Cox regression analysis and Kaplan-Meier analysis. Receiver operating characteristic curve analysis was calculated to find the optimal sensitivity, specificity, and cutoff values of the variables. The reproducibility of the results obtained was verified in a different but related group of patients.
results56 patients (28.7%) had re-bleeding within 6 weeks; HCCPHTIS was an independent risk factor for variceal re-bleeding after AVB (Odd ratio, 2.330; 95% confidence interval: 1.728-3.142, p < 0.001). The positive predictive value of HCCPHTIS cut off value > 3 was 66.2%, sensitivity 83.9%, and specificity 82.3%. HCCPHTIS area under the curve was higher than Child-Pugh score (89% vs. 75%, p < 0.001). 74(37.9%) death occurred within 6 weeks; HCCPHTIS > 4 was associated with increased risk of death within 6 weeks after AVB (p < 0.001).
conclusionHCCPHTIS > 3 is a strong predictor of variceal re-bleeding within the first 6 weeks. However, patients with HCCPHTIS > 4 were at increased risk of death within 6 weeks.
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