von Willebrand factor as a biomarker of clinically significant portal hypertension and severe portal hypertension: a systematic review and meta-analysis

Objective This meta-analysis was performed to investigate the correlation between von Willebrand factor (vWF) antigen and hepatic venous pressure gradient (HVPG) and to evaluate the diagnostic performance of vWF to detect clinically significant portal hypertension (CSPH) and severe portal hypertensi...

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Main Authors: Chunqing Zhang, Ziyuan Zou, Xinwen Yan, Cheng Li, Xiaofeng Li, Xiaofen Ma, Shenghong Ju, Junzhang Tian, Xiaolong Qi
Format: Article
Language:English
Published: BMJ Publishing Group 2019-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/8/e025656.full
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author Chunqing Zhang
Ziyuan Zou
Xinwen Yan
Cheng Li
Xiaofeng Li
Xiaofen Ma
Shenghong Ju
Junzhang Tian
Xiaolong Qi
author_facet Chunqing Zhang
Ziyuan Zou
Xinwen Yan
Cheng Li
Xiaofeng Li
Xiaofen Ma
Shenghong Ju
Junzhang Tian
Xiaolong Qi
author_sort Chunqing Zhang
collection DOAJ
description Objective This meta-analysis was performed to investigate the correlation between von Willebrand factor (vWF) antigen and hepatic venous pressure gradient (HVPG) and to evaluate the diagnostic performance of vWF to detect clinically significant portal hypertension (CSPH) and severe portal hypertension (SPH).Design Systematic review and meta-analysis.Methods MEDLINE, EMBASE, Web of Science and the Cochrane Library were screened up to 5 April 2018. Studies related to the diagnostic performance of vWF to detect CSPH and/or SPH with HVPG as the reference standard were included. Study quality was assessed by using the Quality Assessment of Diagnostic Accuracy Studies scale. Two authors independently used a standardised form to extract data.Outcomes The primary outcome was the correlation coefficient between vWF and HVPG. The secondary outcome was the diagnostic performance of vWF to detect CSPH or SPH.Results A total of six articles involving 994 patients were included in this study. Five of the included articles were used to stratify the results for the correlation coefficient, three for the diagnostic performance of CSPH and two for SPH. The pooled correlation coefficient based on the random effects model was 0.54 (95% CI 0.35 to 0.69), thus suggesting a moderate correlation between vWF and HVPG. The pooled sensitivity, specificity and area under the curve of vWF for CSPH detection were 82% (95% CI 78 to 86), 76% (95% CI 68 to 83) and 0.87 (95% CI 0.80 to 0.94), respectively. Regarding the ability of vWF to detect SPH, the pooled sensitivity and specificity were 86% (95% CI 80 to 90) and 75% (95% CI 66 to 83), respectively. These results supported the satisfactory diagnostic performance of vWF for CSPH and SPH detection.Conclusions vWF, as a novel biomarker, has a moderate correlation with HVPG and shows a satisfactory performance for the diagnosis of CSPH and SPH in patients with cirrhosis.
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spelling doaj-art-a0a2387b7f3141f59db5413a96da39e52024-11-26T14:10:12ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2018-025656von Willebrand factor as a biomarker of clinically significant portal hypertension and severe portal hypertension: a systematic review and meta-analysisChunqing Zhang0Ziyuan Zou1Xinwen Yan2Cheng Li3Xiaofeng Li4Xiaofen Ma5Shenghong Ju6Junzhang Tian7Xiaolong Qi8Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, People`s Republic of China1 CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China2 The First School of Clinical Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaGuangdong Traditional Medical and Sports Injury Rehabilitation Research Institute, Guangdong Second Provincial General Hospital, Guangzhou, China4 Second Department of General Surgery, Guangdong Second Provincial General Hospital, Guangzhou, China5 Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China8Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, ChinaCenter for Clinical Epidemiology and Methodology, Guangdong Second Provincial General Hospital, Guangdong, China1 Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing, Jiangsu, ChinaObjective This meta-analysis was performed to investigate the correlation between von Willebrand factor (vWF) antigen and hepatic venous pressure gradient (HVPG) and to evaluate the diagnostic performance of vWF to detect clinically significant portal hypertension (CSPH) and severe portal hypertension (SPH).Design Systematic review and meta-analysis.Methods MEDLINE, EMBASE, Web of Science and the Cochrane Library were screened up to 5 April 2018. Studies related to the diagnostic performance of vWF to detect CSPH and/or SPH with HVPG as the reference standard were included. Study quality was assessed by using the Quality Assessment of Diagnostic Accuracy Studies scale. Two authors independently used a standardised form to extract data.Outcomes The primary outcome was the correlation coefficient between vWF and HVPG. The secondary outcome was the diagnostic performance of vWF to detect CSPH or SPH.Results A total of six articles involving 994 patients were included in this study. Five of the included articles were used to stratify the results for the correlation coefficient, three for the diagnostic performance of CSPH and two for SPH. The pooled correlation coefficient based on the random effects model was 0.54 (95% CI 0.35 to 0.69), thus suggesting a moderate correlation between vWF and HVPG. The pooled sensitivity, specificity and area under the curve of vWF for CSPH detection were 82% (95% CI 78 to 86), 76% (95% CI 68 to 83) and 0.87 (95% CI 0.80 to 0.94), respectively. Regarding the ability of vWF to detect SPH, the pooled sensitivity and specificity were 86% (95% CI 80 to 90) and 75% (95% CI 66 to 83), respectively. These results supported the satisfactory diagnostic performance of vWF for CSPH and SPH detection.Conclusions vWF, as a novel biomarker, has a moderate correlation with HVPG and shows a satisfactory performance for the diagnosis of CSPH and SPH in patients with cirrhosis.https://bmjopen.bmj.com/content/9/8/e025656.full
spellingShingle Chunqing Zhang
Ziyuan Zou
Xinwen Yan
Cheng Li
Xiaofeng Li
Xiaofen Ma
Shenghong Ju
Junzhang Tian
Xiaolong Qi
von Willebrand factor as a biomarker of clinically significant portal hypertension and severe portal hypertension: a systematic review and meta-analysis
BMJ Open
title von Willebrand factor as a biomarker of clinically significant portal hypertension and severe portal hypertension: a systematic review and meta-analysis
title_full von Willebrand factor as a biomarker of clinically significant portal hypertension and severe portal hypertension: a systematic review and meta-analysis
title_fullStr von Willebrand factor as a biomarker of clinically significant portal hypertension and severe portal hypertension: a systematic review and meta-analysis
title_full_unstemmed von Willebrand factor as a biomarker of clinically significant portal hypertension and severe portal hypertension: a systematic review and meta-analysis
title_short von Willebrand factor as a biomarker of clinically significant portal hypertension and severe portal hypertension: a systematic review and meta-analysis
title_sort von willebrand factor as a biomarker of clinically significant portal hypertension and severe portal hypertension a systematic review and meta analysis
url https://bmjopen.bmj.com/content/9/8/e025656.full
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