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病因在肝脏疾病的进展、消退和实质重塑中的作用:对肝活检解读的影响。

Role of aetiology in the progression, regression, and parenchymal remodelling of liver disease: implications for liver biopsy interpretation.

机构信息

Institute of Liver Studies, King's College Hospital and King's College, London, UK.

Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil.

出版信息

Histopathology. 2016 Jun;68(7):953-67. doi: 10.1111/his.12957. Epub 2016 Apr 28.

Abstract

Clinicopathological concepts on acute and chronic liver disease have evolved rapidly during the last few years, with advances in general and specific treatment options and improved patient outcomes. The old paradigm of 'irreversibility' of cirrhosis had been challenged in major ways, and the validity of the usage of the term 'cirrhosis' has come into question. This paper addresses aetiology-based clinicopathological concepts and features that may deserve attention because they may determine disease outcome and, specifically, patterns of regression and remodelling. A variety of therapeutic interventions may influence remaining disease features after elimination of damaging agents (virus, alcohol, etc.), and determine the final clinical outcome including the risk of hepatocellular carcinoma (HCC). New concepts create new responsibilities and opportunities for the pathologist to contribute to the understanding of liver pathology and communicate this with clinical colleagues and researchers.

摘要

近年来,急性和慢性肝病的临床病理概念迅速发展,治疗方法的选择更加具体,患者的预后也得到了改善。肝硬化“不可逆转”的旧观念受到了重大挑战,“肝硬化”这一术语的使用有效性也受到了质疑。本文介绍了基于病因的临床病理概念和特征,这些概念和特征值得关注,因为它们可能决定疾病的结局,特别是消退和重塑的模式。各种治疗干预措施可能会影响消除损伤因子(病毒、酒精等)后剩余的疾病特征,并决定最终的临床结局,包括肝细胞癌(HCC)的风险。新概念为病理学家提供了新的责任和机会,有助于理解肝脏病理学,并与临床同事和研究人员进行交流。

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