Value of D-dimer and protein S for diagnosis of portal vein thrombosis in patients with liver cirrhosis

Objective To investigate the value of D-dimer and protein S plasma concentrations for diagnosis of portal vein thrombosis (PVT) in patients with liver cirrhosis. Methods D-dimer and protein S were quantified, PVT was diagnosed by dynamic enhanced computed tomography and liver function was classified using the Child-Pugh system. Receiver operating curve analysis was performed. Results D-dimer increased, and protein S decreased, with decreasing liver function in the total study population (n=188). D-dimer concentrations were significantly higher and protein S concentrations were significantly lower in patients with (n=51) than those without PVT (n=137). D-dimer had high specificity and negative predictive value (NPV) in Child-Pugh class A or B patients (cut-off values>0.56mg/l and >1.18mg/l, respectively). In class C patients>0.77mg/l D-dimer had high sensitivity and NPV. Protein S had high sensitivity but low specificity in class A or B patients (cut-off values<17.4mg/l and <19.2mg/l, respectively). Conclusion Plasma D-dimer and protein S are potential biomarkers for PVT diagnosis in patients with cirrhosis. PVT can be excluded when D-dimer is low and protein S is elevated.