Scoazec Jean-Yves
Hôpital Édouard-Herriot, Hospices Civils de Lyon, France.
Ann Pathol. 2010 Dec;30(6):464-9. doi: 10.1016/j.annpat.2010.08.026. Epub 2010 Nov 26.
The role of liver biopsy in the management of patients with chronic liver disease has much evolved in the recent years. Its importance in diagnosis, staging and prognosis largely depends on the indication and on the context. In chronic viral hepatitis, the role of liver biopsy has been reduced because of the major developments and improvements in the virological diagnosis of viral infection and because of the recent validation of non-invasive tests for fibrosis evaluation which offer alternative strategies for therapeutic decision and follow-up. Liver biopsy remains however useful for the identification of associated diseases and for the detection of some complications. In many other indications, liver biopsy remains the gold standard for the diagnosis and the staging of the disease. Moreover, guided liver biopsy remains essential for the diagnosis of focal liver lesions.
近年来，肝活检在慢性肝病患者管理中的作用有了很大的发展。其在诊断、分期和预后方面的重要性很大程度上取决于适应证和具体情况。在慢性病毒性肝炎中，由于病毒感染的病毒学诊断取得了重大进展和改进，以及最近用于纤维化评估的非侵入性检测得到验证，这些检测为治疗决策和随访提供了替代策略，肝活检的作用已有所降低。然而，肝活检对于识别相关疾病和检测一些并发症仍然有用。在许多其他适应证中，肝活检仍然是疾病诊断和分期的金标准。此外，引导下肝活检对于局灶性肝病变的诊断仍然至关重要。
