Palacios Pérez Angel, Salmerón Escobar Javier
Unidad Clínica de Aparato Digestivo, Hospital Universitario San Cecilio, Granada, España.
Gastroenterol Hepatol. 2007 Aug-Sep;30(7):402-7. doi: 10.1157/13108806.
For several years, liver biopsy has been the established gold standard for evaluating the status of liver disease in patients with chronic hepatitis C. Although this procedure continues to be recommended, current practice is changing for 2 main reasons: firstly, treatment is more effective and, secondly, biochemical and serological tests provide a great deal of information on disease progression. Pathologists can increase the importance and utility of liver biopsy in chronic hepatitis C, providing information not only on the stage of fibrosis and necroinflammatory activity but also on the grade of steatosis and iron accumulation, which are implicated in disease progression. Moreover, these specialists can identify other diseases, such as steatohepatitis and hereditary hemochromatosis. Nevertheless, the use of serological tests will reduce the indications for liver biopsy.
多年来，肝活检一直是评估慢性丙型肝炎患者肝脏疾病状况的既定金标准。尽管该检查仍被推荐，但目前的做法正在发生变化，主要有两个原因：其一，治疗更有效；其二，生化和血清学检查能提供大量有关疾病进展的信息。病理学家可以提高肝活检在慢性丙型肝炎中的重要性和实用性，不仅提供有关纤维化阶段和坏死性炎症活动的信息，还提供有关脂肪变性和铁蓄积程度的信息，这些都与疾病进展有关。此外，这些专家还可以识别其他疾病，如脂肪性肝炎和遗传性血色素沉着症。然而，血清学检查的使用将减少肝活检的指征。
