Wang Yan, Hou Jin-Lin
Department of Infectious Diseases, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515; Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510280, China.
Chin Med J (Engl). 2015 Jan 20;128(2):252-8. doi: 10.4103/0366-6999.149223.
The present mini-review updated the progress in methodologies based on using liver biopsy.
Articles for study of liver fibrosis, liver biopsy or fibrosis assessment published on high impact peer review journals from 1980 to 2014.
Key articles were selected mainly according to their levels of relevance to this topic and citations.
With the recently mounting progress in chronic liver disease therapeutics, comes by a pressing need for precise, accurate, and dynamic assessment of hepatic fibrosis and cirrhosis in individual patients. Histopathological information is recognized as the most valuable data for fibrosis assessment. Conventional histology categorical systems describe the changes of fibrosis patterns in liver tissue; but the simplified ordinal digits assigned by these systems cannot reflect the fibrosis dynamics with sufficient precision and reproducibility. Morphometric assessment by computer assist digital image analysis, such as collagen proportionate area (CPA), detects change of fibrosis amount in tissue section in a continuous variable, and has shown its independent diagnostic value for assessment of advanced or late-stage of fibrosis. Due to its evident sensitivity to sampling variances, morphometric measurement is feasible to be taken as a reliable statistical parameter for the study of a large cohort. Combining state-of-art imaging technology and fundamental principle in Tissue Engineering, structure-based quantitation was recently initiated with a novel proof-of-concept tool, qFibrosis. qFibrosis showed not only the superior performance to CPA in accurately and reproducibly differentiating adjacent stages of fibrosis, but also the possibility for facilitating analysis of fibrotic regression and cirrhosis sub-staging.
With input from multidisciplinary innovation, liver biopsy assessment as a new "gold standard" is anticipated to substantially support the accelerated progress of Hepatology medicine.
本综述更新了基于肝活检方法的研究进展。
1980年至2014年在高影响力同行评审期刊上发表的关于肝纤维化、肝活检或纤维化评估的研究文章。
主要根据文章与本主题的相关性水平和引用次数来选择关键文章。
随着慢性肝病治疗领域最近取得的进展，迫切需要对个体患者的肝纤维化和肝硬化进行精确、准确和动态的评估。组织病理学信息被认为是纤维化评估中最有价值的数据。传统的组织学分类系统描述了肝组织中纤维化模式的变化；但这些系统所赋予的简化序数数字不能以足够的精度和可重复性反映纤维化动态。通过计算机辅助数字图像分析进行的形态计量评估，如胶原比例面积（CPA），以连续变量检测组织切片中纤维化量的变化，并已显示出其在评估晚期纤维化方面的独立诊断价值。由于其对抽样差异具有明显的敏感性，形态计量测量可作为研究大型队列的可靠统计参数。结合先进的成像技术和组织工程的基本原理，最近利用一种新型的概念验证工具qFibrosis启动了基于结构的定量分析。qFibrosis不仅在准确和可重复地区分相邻纤维化阶段方面表现优于CPA，而且还具有促进纤维化消退分析和肝硬化亚分期的可能性。
在多学科创新的推动下，肝活检评估作为一种新的“金标准”有望为肝病医学的加速发展提供有力支持。
