Early Changes in Spleen Stiffness After Endoscopic Treatment Are Associated with Esophageal Variceal Recurrence: A Pilot Study
- 1Department of Gastroenterology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan
Abstract
Background: Spleen stiffness (SS) is a noninvasive marker of portal hypertension; however, the clinical significance of early changes in SS after endoscopic treatment for esophageal varices remains unclear. We evaluated whether SS and its early post-treatment changes are associated with variceal recurrence. Methods: This retrospective pilot study included 20 patients who underwent endoscopic treatment for esophageal varices. Liver stiffness (LS) and spleen stiffness (SS) were measured before treatment, approximately 1 week after the final treatment session (1W), and at 1 month and 1 year after treatment. The clinical outcome of interest was variceal recurrence within 1 year. Early changes in stiffness were calculated from 1W to 1M (Δ1M − 1W). Results: Eleven patients (55.0%) developed variceal recurrence. LS did not differ significantly between the non-recurrence and recurrence groups at any time point during follow-up. SS was comparable between the groups before treatment and at 1W but was significantly higher in the recurrence group at 1M (median [IQR], 2.75 [2.70–2.86] vs. 3.40 [3.06–3.81] m/s in the non-recurrence and recurrence groups, respectively; p = 0.003). ΔSS-VTQ (1M − 1W) was significantly greater in the recurrence group than in the non-recurrence group (−0.13 [−0.62–−0.04] vs. 0.25 [−0.05–0.40] m/s, respectively; p = 0.013), whereas no significant between-group differences were observed in changes in LS. Conclusions: SS at 1 month after endoscopic treatment and its early post-treatment change were associated with variceal recurrence. Serial assessment of SS may provide useful information for early post-treatment risk assessment, although validation in larger prospective studies is needed.
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BibTeX
@article{uchiyama2026early,
title = {{Early Changes in Spleen Stiffness After Endoscopic Treatment Are Associated with Esophageal Variceal Recurrence: A Pilot Study}},
author = {Akira Uchiyama and Shunhei Yamashina and Satoshi Sakuma and Masahiro Tada and Kei Ishizuka and Maki Morinaga and Hiroo Fukada and Reiko Yaginuma and Kyoko Fukuhara and Kazuyoshi Kon and Kenichi Ikejima},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207868},
url = {https://www.mdpi.com/2077-0383/15/20/7868},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Early Changes in Spleen Stiffness After Endoscopic Treatment Are Associated with Esophageal Variceal Recurrence: A Pilot Study
AU - Akira Uchiyama
AU - Shunhei Yamashina
AU - Satoshi Sakuma
AU - Masahiro Tada
AU - Kei Ishizuka
AU - Maki Morinaga
AU - Hiroo Fukada
AU - Reiko Yaginuma
AU - Kyoko Fukuhara
AU - Kazuyoshi Kon
AU - Kenichi Ikejima
PY - 2026
DA - 2026/10/12
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207868
UR - https://www.mdpi.com/2077-0383/15/20/7868
AB - Background: Spleen stiffness (SS) is a noninvasive marker of portal hypertension; however, the clinical significance of early changes in SS after endoscopic treatment for esophageal varices remains unclear. We evaluated whether SS and its early post-treatment changes are associated with variceal recurrence. Methods: This retrospective pilot study included 20 patients who underwent endoscopic treatment for esophageal varices. Liver stiffness (LS) and spleen stiffness (SS) were measured before treatment, approximately 1 week after the final treatment session (1W), and at 1 month and 1 year after treatment. The clinical outcome of interest was variceal recurrence within 1 year. Early changes in stiffness were calculated from 1W to 1M (Δ1M − 1W). Results: Eleven patients (55.0%) developed variceal recurrence. LS did not differ significantly between the non-recurrence and recurrence groups at any time point during follow-up. SS was comparable between the groups before treatment and at 1W but was significantly higher in the recurrence group at 1M (median [IQR], 2.75 [2.70–2.86] vs. 3.40 [3.06–3.81] m/s in the non-recurrence and recurrence groups, respectively; p = 0.003). ΔSS-VTQ (1M − 1W) was significantly greater in the recurrence group than in the non-recurrence group (−0.13 [−0.62–−0.04] vs. 0.25 [−0.05–0.40] m/s, respectively; p = 0.013), whereas no significant between-group differences were observed in changes in LS. Conclusions: SS at 1 month after endoscopic treatment and its early post-treatment change were associated with variceal recurrence. Serial assessment of SS may provide useful information for early post-treatment risk assessment, although validation in larger prospective studies is needed.
SN - 2077-0383
ER -