The Royal Free Sheila Sherlock Liver Centre, London, United Kingdom.
Semin Liver Dis. 2011 Feb;31(1):82-90. doi: 10.1055/s-0031-1272836. Epub 2011 Feb 22.
The liver biopsy specimen represents valuable material for the assessment of fibrosis and cirrhosis. Despite limitations related to sampling and interpretation, histologic examination remains the gold standard for staging chronic liver diseases. Hepatic fibrosis is currently viewed as a dynamic process that may often regress after successful treatment of chronic liver diseases. Even the excess fibrous tissue of cirrhotic livers may sometimes regress over time. Distinguishing between the amount of hepatic fibrosis and the disease stage is important for the assessment of the effects of antifibrotic treatments. Recent studies suggest that the proportion of the liver biopsy specimen occupied by collagen is correlated with the hepatic venous pressure gradient in liver transplant recipients with hepatitis C virus infection, with or without cirrhosis, and represents a predictor of clinical decompensation. This parameter has also been found to correlate with liver stiffness measurements of patients with chronic viral hepatitis obtained by transient elastography. Therefore, quantitative assessment of hepatic fibrosis in liver biopsy specimens holds promise as a prognostic marker, and as a means to validate noninvasive markers of fibrosis.
肝活检标本是评估纤维化和肝硬化的有价值的材料。尽管存在与采样和解释相关的局限性，但组织学检查仍然是慢性肝病分期的金标准。肝纤维化目前被视为一个动态过程，在慢性肝病得到成功治疗后可能经常消退。即使肝硬化肝脏的多余纤维组织也可能随着时间的推移而消退。区分肝纤维化的程度和疾病阶段对于评估抗纤维化治疗的效果很重要。最近的研究表明，在感染丙型肝炎病毒的肝移植受者中，无论是否存在肝硬化，肝活检标本中胶原所占的比例与肝静脉压力梯度相关，并且是临床失代偿的预测指标。还发现该参数与通过瞬时弹性成像获得的慢性病毒性肝炎患者的肝硬度测量值相关。因此，肝活检标本中肝纤维化的定量评估有望成为一种预后标志物，并作为验证纤维化非侵入性标志物的手段。
