Chowdhury Aqib B, Mehta Kosha J
GKT School of Medical Education, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Centre for Education, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Clin Exp Med. 2023 Jun;23(2):273-285. doi: 10.1007/s10238-022-00799-z. Epub 2022 Feb 22.
The world-wide increase in chronic liver disease (CLD) calls for refinement of diagnostic and prognostic measures for early and accurate disease detection and management. Regardless of the aetiology, liver biopsy allows direct visualisation of specimen under the microscope. It facilitates histological evaluation of disease-specific morphological alterations. Thereby, it aids in disease diagnosis, prognosis, and assessment of treatment compliance/response. Indeed, with the advent of non-invasive methods, liver biopsy is used less frequently than before, but it is still considered as a gold standard for staging and grading several CLDs. This short review revisits liver biopsy. It highlights the significance of liver biopsy in evaluating CLDs and explains the commonly used Ishak, METAVIR and Batts-Ludwig scoring systems for grading and staging CLDs. The utility of liver biopsy in examining alcohol-related liver disease and non-alcoholic fatty liver disease (NAFLD) is discussed along with the disease-specific alcoholic hepatitis histology score (AHHS) and non-alcoholic fatty liver disease activity score (NAS). Additionally, the review elaborates on the role of liver biopsy in evaluating viral hepatitis, haemochromatosis, and hepatocellular carcinoma. Contextual explanation on the diagnosis of metabolic dysfunction-associated liver disease (MAFLD) is provided. The significance and clinical indications of repeat biopsy are also explained. Lastly, caveats and limitations associated with liver biopsy are reviewed. Essentially, this review collates the application of liver biopsy in assessing various CLDs and provides succinct explanations of the core scoring systems, all under one roof. It is clinically relevant and provides a useful synopsis to budding scientists and hepato-pathologists.
全球慢性肝病（CLD）的增加促使人们改进诊断和预后措施，以便早期准确地检测和管理疾病。无论病因如何，肝活检都能在显微镜下直接观察标本。它有助于对疾病特异性形态学改变进行组织学评估。因此，它有助于疾病的诊断、预后评估以及治疗依从性/反应的评估。的确，随着非侵入性方法的出现，肝活检的使用频率比以前降低了，但它仍然被认为是几种CLD分期和分级的金标准。这篇简短的综述重新审视了肝活检。它强调了肝活检在评估CLD中的重要性，并解释了常用的Ishak、METAVIR和Batts-Ludwig评分系统用于CLD的分级和分期。还讨论了肝活检在检查酒精性肝病和非酒精性脂肪性肝病（NAFLD）中的作用，以及疾病特异性的酒精性肝炎组织学评分（AHHS）和非酒精性脂肪性肝病活动评分（NAS）。此外，该综述阐述了肝活检在评估病毒性肝炎、血色素沉着症和肝细胞癌中的作用。提供了关于代谢功能障碍相关肝病（MAFLD）诊断的背景解释。还解释了重复活检的意义和临床指征。最后，回顾了与肝活检相关的注意事项和局限性。从本质上讲，这篇综述整理了肝活检在评估各种CLD中的应用，并对核心评分系统进行了简洁的解释，都集中在一篇文章中。它具有临床相关性，为初出茅庐的科学家和肝脏病理学家提供了有用的概要。
