Karanjia Rustam N, Crossey Mary M E, Cox I Jane, Fye Haddy K S, Njie Ramou, Goldin Robert D, Taylor-Robinson Simon D
Rustam N Karanjia, Mary ME Crossey, Robert D Goldin, Simon D Taylor-Robinson, Liver Unit, Division of Digestive Health, Department of Surgery and Cancer, Imperial College London, St Mary's Campus, London W2 1NY, United Kingdom.
World J Gastroenterol. 2016 Dec 7;22(45):9880-9897. doi: 10.3748/wjg.v22.i45.9880.
Chronic liver disease is a major cause of morbidity and mortality worldwide and usually develops over many years, as a result of chronic inflammation and scarring, resulting in end-stage liver disease and its complications. The progression of disease is characterised by ongoing inflammation and consequent fibrosis, although hepatic steatosis is increasingly being recognised as an important pathological feature of disease, rather than being simply an innocent bystander. However, the current gold standard method of quantifying and staging liver disease, histological analysis by liver biopsy, has several limitations and can have associated morbidity and even mortality. Therefore, there is a clear need for safe and non-invasive assessment modalities to determine hepatic steatosis, inflammation and fibrosis. This review covers key mechanisms and the importance of fibrosis and steatosis in the progression of liver disease. We address non-invasive imaging and blood biomarker assessments that can be used as an alternative to information gained on liver biopsy.
慢性肝病是全球发病和死亡的主要原因，通常会在多年间因慢性炎症和瘢痕形成而发展，导致终末期肝病及其并发症。疾病的进展以持续炎症和随之而来的纤维化为特征，尽管肝脂肪变性越来越被认为是疾病的一个重要病理特征，而不仅仅是一个无辜的旁观者。然而，目前量化和分期肝病的金标准方法——肝活检组织学分析，有几个局限性，并且可能伴有发病率甚至死亡率。因此，显然需要安全且非侵入性的评估方式来确定肝脂肪变性、炎症和纤维化。本综述涵盖了纤维化和脂肪变性在肝病进展中的关键机制及其重要性。我们讨论了可替代肝活检所获信息的非侵入性成像和血液生物标志物评估。
