Non-invasive markers for hepatic fibrosis.
Non-invasive markers for hepatic fibrosis.
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DOI：
10.1186/1471-230x-11-91
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发表时间：
2011-08-17
影响因子：
2.4
通讯作者：
Younossi ZM
中科院分区：
文献类型：
--
作者：
Baranova A;Lal P;Birerdinc A;Younossi ZM
随着用于治疗慢性肝病的治疗方式的巨大进步，肝纤维化的准确评估是成功个体化管理患者疾病活动的重要需求。缺乏准确、可重复和易于应用的纤维化评估方法一直是临床管理和肝病研究的主要限制。然而，开发能够对肝脏中的纤维化进行非侵入性分期的生物标志物的问题是困难的，这是由于纤维形成的过程是对损伤、病原体入侵和许多其他病因因素的正常愈合反应的组成部分。目前的非侵入性方法范围从血清生物标志物测定到先进的成像技术，如瞬时弹性成像和磁共振成像（MRI）。在非侵入性方法中，获得最强的临床立足点是FibroScan弹性测量和基于血清的APRI和FibroTest。还有许多其他测试尚未得到广泛验证，但仍然很有希望。采用非侵入性肝纤维化诊断检测的比率因国家而异，但仍然有限。目前，可以推荐使用非侵入性程序作为预筛选，这可以允许医生在通过肝脏活检进行肝纤维化的确定性检测之前缩小患者人群。本文综述了这些技术的系统概述，以及用于分期纤维化的直接和间接生物标志物方法，并涵盖了这一快速发展领域的最新进展。
With great advancements in the therapeutic modalities used for the treatment of chronic liver diseases, the accurate assessment of liver fibrosis is a vital need for successful individualized management of disease activity in patients. The lack of accurate, reproducible and easily applied methods for fibrosis assessment has been the major limitation in both the clinical management and for research in liver diseases. However, the problem of the development of biomarkers capable of non-invasive staging of fibrosis in the liver is difficult due to the fact that the process of fibrogenesis is a component of the normal healing response to injury, invasion by pathogens, and many other etiologic factors. Current non-invasive methods range from serum biomarker assays to advanced imaging techniques such as transient elastography and magnetic resonance imaging (MRI). Among non-invasive methods that gain strongest clinical foothold are FibroScan elastometry and serum-based APRI and FibroTest. There are many other tests that are not yet widely validated, but are none the less, promising. The rate of adoption of non-invasive diagnostic tests for liver fibrosis differs from country to country, but remains limited. At the present time, use of non-invasive procedures could be recommended as pre-screening that may allow physicians to narrow down the patients' population before definitive testing of liver fibrosis by biopsy of the liver. This review provides a systematic overview of these techniques, as well as both direct and indirect biomarkers based approaches used to stage fibrosis and covers recent developments in this rapidly advancing area.