University of California Davis, Pathology and Laboratory Medicine, 4400 V Street, Sacramento, CA 95817, USA.
University of Washington Medical Center - Montlake, Box 356100, 1959 NE Pacific Street, Seattle, WA 98195, USA.
Surg Pathol Clin. 2023 Sep;16(3):457-472. doi: 10.1016/j.path.2023.04.002. Epub 2023 Jun 4.
Liver fibrosis staging has many challenges, including the large number of proposed staging systems, the heterogeneity of the histopathologic changes of many primary liver diseases, and the potential for slight differences in histologic interpretation to significantly affect clinical management. This review focuses first on fibrosis regression. Following this, each of the major categories of liver disease is discussed in regard to (1) appropriate fibrosis staging systems, (2) emerging concepts, (3) current clinical indications for liver biopsy, (4) clinical decisions determined by fibrosis stage, and (5) histologic challenges and pitfalls related to staging.
肝纤维化分期面临诸多挑战，包括所提出的分期系统众多、许多原发性肝病的组织病理学变化具有异质性，以及组织学解释的细微差异可能对临床管理产生重大影响。本综述首先关注纤维化消退。此后，每种主要类型的肝病都将分别讨论以下方面：（1）适当的纤维化分期系统；（2）新出现的概念；（3）肝活检的当前临床适应证；（4）根据纤维化分期做出的临床决策；以及（5）与分期相关的组织学挑战和陷阱。
