Tanaka Yasuo
Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo 162-8655, Japan.
World J Hepatol. 2024 Jan 27;16(1):12-16. doi: 10.4254/wjh.v16.i1.12.
Hepatitis C virus (HCV) remains a significant public health problem as it can cause acute and chronic hepatitis. Chronic HCV infection is a major cause of liver fibrosis, and evaluation of liver fibrosis is essential because the prognosis of patients with chronic HCV infection is closely related to the stage of fibrosis. Liver fibrosis is traditionally evaluated based on pathological analysis of biopsy specimens, which is considered the gold standard. Nevertheless, liver biopsy is invasive and susceptible to sampling error and inter- and intraobserver variation in pathological interpretation; it is also costly. Therefore, noninvasive diagnostic investigations have been developed, including the use of fibrotic markers, scoring systems based on routine blood tests, and transient elastography with magnetic resonance imaging or ultrasonography. Recently, metabolomics, an emerging technology, has been used to detect the fibrosis stage. In this editorial, I comment on the article titled "Metabolomics in chronic hepatitis C: Decoding fibrosis grading and underlying pathways" by Ferrasi published in the recent issue of the . I discuss previous studies on the use of metabolome analysis for the diagnosis of HCV-related liver fibrosis and the potential development of biopsy-free diagnostic techniques.
丙型肝炎病毒（HCV）仍然是一个重大的公共卫生问题，因为它可导致急性和慢性肝炎。慢性HCV感染是肝纤维化的主要原因，肝纤维化评估至关重要，因为慢性HCV感染患者的预后与纤维化阶段密切相关。传统上，肝纤维化是根据活检标本的病理分析来评估的，这被认为是金标准。然而，肝活检具有侵入性，容易出现抽样误差以及病理解读中的观察者间和观察者内差异；而且成本高昂。因此，已开发出非侵入性诊断方法，包括使用纤维化标志物、基于常规血液检测的评分系统以及磁共振成像或超声的瞬时弹性成像。最近，代谢组学这一新兴技术已被用于检测纤维化阶段。在这篇社论中，我对费拉西发表在最近一期《 》上的题为“慢性丙型肝炎中的代谢组学：解读纤维化分级及潜在途径”的文章进行评论。我讨论了以往关于使用代谢组分析诊断HCV相关肝纤维化的研究以及无活检诊断技术的潜在发展。
