Serum MFAP4 as a Non Invasive Diagnostic Marker of Oesophageal Varices in Cirrhotic Hepatitis C Virus Patients

Background and study aim: HCV induced liver cirrhosis is the primary cause of liver-related mortality, with liver disease ranking as the world's tenth greatest cause of death. The portal pressure remains below the threshold at which varices develop during the compensated phase. Conversely, those who are decompensated get clinically evident portal hypertension. MFAP4 was first proposed as a new prospective parameter for fibrotic liver disease after recent research showed that it is one of the substantially elevated proteins in fibrotic liver. The purpose of this investigation was to assess the efficacy of serum MFAP4 as a diagnostic biomarker for identifying OV in HCV induced liver cirrhosis patients. It also compared the effectiveness of MFAP4 with other non-invasive markers, as well as upper gastrointestinal endoscopic findings across different grades of OV Patients and Methods: Our study was carried out on ninety participants which were divided into four groups after doing upper GIT endoscopy: group I (n = 20) consisted of patients without oesophageal varices; group II (n = 25) had small varices; group IIIa (n = 25) consisted of large size varices; group IIIb consisted of the same patients as group IIIa but after eradicated varices; group IV (n=20) as healthy control group. Routine laboratory investigations (CBC, liver and renal functions), non-invasive marker of liver fibrosis were done and our main study marker serum level of MFAP4 was assessed via ELISA. Results: All cirrhotic patients had serum MFAP4 levels that were statistically considerably greater than those of control group (p = <0.001). Additionally, its level was higher in patients with large varices as opposed to patients without varices or small varices (p < 0.001) and in patients with small varices as opposed to those without varices (p = <0.001). Nevertheless, p = 0.082 indicates that groups IIIa and IIIb were not statistically different. Serum MFAP4 did not correlate with the APRI or FIB-4 in any of the studied groups, with the exception of patients with large varices, who showed a negative correlation with the APRI score. Conclusion: Serum MFAP4 may be used as a useful non-invasive biomarker of oesophageal varices in cirrhotic patients and its grading, but not after esophageal varices eradication.