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Abstract
The screening of gastroesophageal varices (GEV) is critical in hepatocellular carcinoma (HCC) management. Contrast-enhanced computed tomography (CECT) is often performed in patients with HCC. Therefore, this study aimed to examine the use of CECT in screening for GEV and predicting GEV bleeding. This retrospective study enrolled 312 consecutive patients who are initially diagnosed with HCC, measured the lower esophageal (EIV) and fundal intramural vessel (FIV) diameter on CECT, examined the changes after 1, 2, and 3 years, and verified the relationship with GEV bleeding. The EIV and FIV diameter on CECT correlates well with endoscopic variceal classification. EIV significantly worsened after 2 and 3 years. FIV showed worsening at both 1, 2, and 3 years. Cumulative GEV bleeding rates were 3.7% at 1 year and 6.2% at 3 years. The multivariate analysis revealed that EIV, FIV, and portal vein tumor thrombus were associated with GEV bleeding. Furthermore, EIV deterioration at 1, 2, and 3 years correlated with GEV bleeding. In conclusion, CECT is useful in variceal management during the longitudinal clinical course of HCC, and has the potential to decrease screening endoscopy. With deterioration in EIV, treatments should be considered due to a high-risk GEV bleeding.
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Details
1 Chiba University, Department of Gastroenterology, Graduate School of Medicine, Chuo-Ku, Chiba, Japan (GRID:grid.136304.3) (ISNI:0000 0004 0370 1101)
2 Chiba University, Department of Gastroenterology, Graduate School of Medicine, Chuo-Ku, Chiba, Japan (GRID:grid.136304.3) (ISNI:0000 0004 0370 1101); Chiba University Hospital, Translational Research and Development Center, Chiba, Japan (GRID:grid.411321.4) (ISNI:0000 0004 0632 2959)
3 Tokyo Women’s Medical University Yachiyo Medical Center, Department of Gastroenterology, Chiba, Japan (GRID:grid.410818.4) (ISNI:0000 0001 0720 6587)