Bedossa Pierre
Department of Pathology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, INSERM, Paris-Diderot University, Paris, France.
Liver Int. 2009 Jan;29 Suppl 1:19-22. doi: 10.1111/j.1478-3231.2008.01940.x.
Chronic viral hepatitis is a prolonged inflammatory disease of the liver that may lead to the development of fibrosis, necro-inflammation and other associated pathological features. Because fibrosis and its end-point cirrhosis are the main causes of morbidity and mortality, fibrosis assessment is considered as the most relevant information for the evaluation of the severity of the disease and as a useful indicator for prognosis and treatment decision. Because fibrosis implies morphological damage, liver biopsy has come to be the natural gold standard for staging the disease. However, the high prevalence of chronic hepatitis C in addition to the cost and constraints generated by this procedure have triggered an intensive search for alternative methods for fibrosis evaluation. In this article, the strengths and weaknesses of liver biopsy and of non-invasive markers will be reviewed and their respective roles in management of patients with chronic hepatitis C will be discussed.
慢性病毒性肝炎是一种肝脏的慢性炎症性疾病，可能导致纤维化、坏死性炎症及其他相关病理特征的出现。由于纤维化及其终末期肝硬化是发病和死亡的主要原因，纤维化评估被视为评估疾病严重程度的最相关信息，也是预后和治疗决策的有用指标。由于纤维化意味着形态学损伤，肝活检已成为该疾病分期的自然金标准。然而，丙型肝炎的高流行率，以及该检查所产生的成本和限制，引发了对纤维化评估替代方法的深入探索。在本文中，将对肝活检和非侵入性标志物的优缺点进行综述，并讨论它们在丙型肝炎患者管理中的各自作用。
