Current strategies for quantitating fibrosis in liver biopsy.
Current strategies for quantitating fibrosis in liver biopsy.
复制标题
当前肝活检中纤维化定量策略
DOI：
10.4103/0366-6999.149223
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发表时间：
2015-01-20
影响因子：
6.1
通讯作者：
Hou JL
中科院分区：
文献类型：
--
作者：
Wang Y;Hou JL
本文综述了以肝活检为基础的方法学研究进展。1980年至2014年期间，在高影响力同行评审期刊上发表的肝纤维化研究、肝活检或纤维化评估的文章。主要根据与本主题的相关程度和引用情况选择关键文章。随着近年来慢性肝病治疗的不断发展，迫切需要对个体患者的肝纤维化和肝硬化进行精确，准确和动态的评估。组织学信息被认为是纤维化评估的最有价值的数据。传统的组织学分类系统描述了肝组织中纤维化模式的变化;但这些系统分配的简化序数数字不能以足够的精度和再现性反映纤维化动力学。通过计算机辅助数字图像分析的形态学评估，如胶原比例面积（CPA），以连续变量检测组织切片中纤维化量的变化，并已显示其对评估晚期或晚期纤维化的独立诊断价值。由于形态测量对样本方差的敏感性，它可以作为一个可靠的统计学参数用于大群体的研究。结合最先进的成像技术和组织工程的基本原理，基于结构的定量最近开始与一种新的概念验证工具，qFibrosis。qFibrosis不仅在准确和可重复地区分相邻纤维化阶段方面表现出优于CPA的上级性能，而且还可能促进纤维化消退和肝硬化亚阶段的分析。随着多学科创新的投入，肝活检评估作为新的“金标准”预计将大大支持肝病医学的加速发展。
The present mini-review updated the progress in methodologies based on using liver biopsy. Articles for study of liver fibrosis, liver biopsy or fibrosis assessment published on high impact peer review journals from 1980 to 2014. Key articles were selected mainly according to their levels of relevance to this topic and citations. With the recently mounting progress in chronic liver disease therapeutics, comes by a pressing need for precise, accurate, and dynamic assessment of hepatic fibrosis and cirrhosis in individual patients. Histopathological information is recognized as the most valuable data for fibrosis assessment. Conventional histology categorical systems describe the changes of fibrosis patterns in liver tissue; but the simplified ordinal digits assigned by these systems cannot reflect the fibrosis dynamics with sufficient precision and reproducibility. Morphometric assessment by computer assist digital image analysis, such as collagen proportionate area (CPA), detects change of fibrosis amount in tissue section in a continuous variable, and has shown its independent diagnostic value for assessment of advanced or late-stage of fibrosis. Due to its evident sensitivity to sampling variances, morphometric measurement is feasible to be taken as a reliable statistical parameter for the study of a large cohort. Combining state-of-art imaging technology and fundamental principle in Tissue Engineering, structure-based quantitation was recently initiated with a novel proof-of-concept tool, qFibrosis. qFibrosis showed not only the superior performance to CPA in accurately and reproducibly differentiating adjacent stages of fibrosis, but also the possibility for facilitating analysis of fibrotic regression and cirrhosis sub-staging. With input from multidisciplinary innovation, liver biopsy assessment as a new “gold standard” is anticipated to substantially support the accelerated progress of Hepatology medicine.