Department of Basic Biomedical Sciences, Liver Cell Biology Laboratory, Vrije Universiteit Brussel, Brussels, Belgium.
Department of Basic Biomedical Sciences, Liver Cell Biology Laboratory, Vrije Universiteit Brussel, Brussels, Belgium; Department of Gastro-enterology and Hepatology, Universitair Ziekenhuis Brussel, Brussels, Belgium.
Biochim Biophys Acta Mol Basis Dis. 2018 Apr;1864(4 Pt A):1024-1036. doi: 10.1016/j.bbadis.2018.01.009. Epub 2018 Jan 9.
Liver fibrosis is the result of persistent liver injury, and is characterized by sustained scar formation and disruption of the normal liver architecture. The extent of fibrosis is considered as an important prognostic factor for the patient outcome, as an absence of (early) treatment can lead to the development of liver cirrhosis and hepatocellular carcinoma. Till date, the most sensitive and specific way for the diagnosis and staging of liver fibrosis remains liver biopsy, an invasive diagnostic tool, which is associated with high costs and discomfort for the patient. Over time, non-invasive scoring systems have been developed, of which the measurements of serum markers and liver stiffness are validated for use in the clinic. These tools lack however the sensitivity and specificity to detect small changes in the progression or regression of both early and late stages of fibrosis. Novel non-invasive diagnostic markers with the potential to overcome these limitations have been developed, but often lack validation in large patient cohorts. In this review, we will summarize novel trends in non-invasive markers of liver fibrosis development and will discuss their (dis-)advantages for use in the clinic.
肝纤维化是持续性肝损伤的结果，其特征是持续的瘢痕形成和正常肝结构的破坏。纤维化的程度被认为是患者预后的一个重要预测因素，因为如果不进行（早期）治疗，可能会导致肝硬化和肝细胞癌的发展。迄今为止，诊断和分期肝纤维化最敏感和最特异的方法仍然是肝活检，这是一种有创的诊断工具，费用高且患者不适。随着时间的推移，已经开发出了非侵入性评分系统，其中血清标志物和肝硬度的测量已被验证可在临床上使用。然而，这些工具缺乏检测纤维化早期和晚期进展或消退的微小变化的敏感性和特异性。已经开发出具有潜在克服这些局限性的新型非侵入性诊断标志物，但在大型患者队列中往往缺乏验证。在这篇综述中，我们将总结肝纤维化发展的新型非侵入性标志物的新趋势，并讨论它们在临床上的（优）缺点。
