Histological Grading and Staging of Chronic Hepatitis.
Histological Grading and Staging of Chronic Hepatitis.
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DOI：
10.1002/cld.1014
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发表时间：
2021-04-01
影响因子：
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通讯作者：
Krishna, Murli
中科院分区：
文献类型：
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作者：
Krishna, Murli
肝活检通常是评估肝功能异常患者的重要组成部分。这是唯一可以直接显示肝损伤程度的手术。如果功能障碍的病因尚不清楚或涉及多种可能的原因，活检结果可以指导临床团队进行诊断和适当的临床管理。在已知的慢性肝炎 (CH) 情况下，活检可提供以下信息：(1) 持续坏死性炎症活动的程度，这是纤维形成的前兆； (2)纤维化的程度。这两个变量与肿瘤过程进行了比较，因此分别称为“等级”和“阶段”。此外，活检可能会揭示其他可能影响预后和治疗的并发过程（例如脂肪肝疾病和铁超负荷）。本综述仅限于 CH 的分级和分期，例如病毒性肝炎和自身免疫性肝炎，不包括脂肪性肝炎的讨论。它概述了分级和分期的目标和基本要素、历史视角以及当前常用的系统。 1-3
The liver biopsy is often an important part of the evaluation of a patient with abnormal liver function. It is the only procedure that provides a direct visualization of the extent of liver injury. If the etiology of dysfunction is not clear or involves multiple possible causes, the biopsy findings may guide the clinical team toward establishing a diagnosis and appropriate clinical management. In the setting of a known chronic hepatitis (CH), a biopsy provides information regarding:(1) the extent of ongoing necroinflammatory activity, which is a precursor to fibrogenesis; and (2) the extent of fibrosis. These two variables have drawn comparisons with neoplastic processes and have thus been termed “grade” and “stage,” respectively. In addition, the biopsy may reveal other concurrent processes (such as fatty liver disease and iron overload) that may influence the prognosis and management. This review is limited to grading and staging of CH, such as viral and autoimmune hepatitis, and does not include discussion of steatohepatitis. It outlines the goals and basic elements of grading and staging, a historical perspective, and the common currently used systems. 1-3