Research advances in noninvasive diagnostic methods for nonalcoholic steatohepatitis
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摘要: 非酒精性脂肪性肝病从发病率方面来看已成为全球第一大肝病,并且正在逐渐成为发达国家肝移植的是首位病因,其疾病谱包括单纯性脂肪肝、非酒精性脂肪性肝炎(NASH)、肝纤维化及肝硬化,与单纯性脂肪肝相比,NASH并非良性疾病,可发展为晚期肝硬化及肝癌。目前NASH诊断的金标准为肝活组织检查,但因有侵入性及潜在的并发症出现几率而限制了其广泛应用。目前临床上尝试采用非侵入性诊断方法替代肝穿刺活组织检查来诊断NASH,但尚缺乏成熟可靠的无创判定方法,因此仍需要不断努力探索改进。现将近年来国内外对NASH无创诊断方法的有关进展作一概述。Abstract: Nonalcoholic fatty liver disease ( NAFLD) has become the most common liver disease in the world in terms of incidence rate and is gradually becoming the first cause of liver transplantation in developed countries. The spectrum of this disease includes simple fatty liver, nonalcoholic steatohepatitis ( NASH) , liver fibrosis, and liver cirrhosis. Compared with simple fatty liver, NASH is not a benign disease and can progress to advanced cirrhosis and liver cancer. At present, liver biopsy remains the gold standard for the diagnosis of NASH, but its application is limited by its invasive and potential complications. Noninvasive diagnostic methods have been developed for the diagnosis of NASH in clinical practice to replace liver biopsy; however, there still lack mature and reliable noninvasive methods, and continuous efforts should be made for further exploration and modification. This article reviews the recent research advances in noninvasive diagnostic methods for NASH in China and foreign countries.
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[1]SCHWENGER KJ, ALLARD JP.Clinical approaches to non-alcoholic fatty liver disease[J].World J Gastroenterol, 2014, 20 (7) :1712-1723. [2]WANG FS, FAN JG, ZHANG Z, et al.The global burden of liver disease:the major impact of China[J].Hepatology, 2014, 60 (6) :2099-2108. [3]MATO JM, LU SC.Where are we in the search for noninvasive nonalcoholic steatohepatitis biomarkers?[J].Hepatology, 2011, 54 (4) :1115-1117. [4]MEHTA SR, THOMAS EL, BELL JD, et al.Non-invasive means of measuring hepatic fat content[J].Word J Gastroenterol, 2008, 14 (22) :3476-3483. [5]CASTERA L, VILGRAIN V, ANGULO P.Noninvasive evaluation of NAFLD[J].Nat Rev Gastroenterol Hepatol, 2013, 10 (11) :666-675. [6]SAADEH S, YOUNOSSI ZM, REMER EM, et al.The utility of radiological imaging in nonalcoholic fatty liver disease[J].Gastroenterology, 2002, 123 (3) :745-750. [7]WONG VW, VERGNIOL J, WONG GL, et al.Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease[J].Hepatology, 2010, 51 (2) :454-462. [8]VUPPALANCHI R, SIDDIQUI MS, van NATTA ML, et al.Performance characteristics of vibration-controlled transient elastography for evaluation of non-alcoholic fatty liver disease[J].Hepatology, 2017.[Epub ahead of print] [9]CHEN J, TALWALKAR JA, YIN M, et al.Early detection of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease by using MR elastography[J].Radiology, 2011, 259 (3) :749-756. [10]TANG A, TAN J, SUN M, et al.Nonalcoholic fatty liver disease:MR imaging of liver proton density fat fraction to assess hepatic steatosis[J].Radiology, 2013, 267 (2) :422-431. [11]CAO W, ZHAO C, SHEN C, et al.Cytokeratin 18, alanine aminotransferase, platelets and triglycerides predict the presence of nonalcoholic steatohepatitis[J].PLo S One, 2013, 8 (12) :e82092. [12]YILMAZ Y, DOLAR E, ULUKAYA E, et al.Solubleforms of extracellular cytokeratin 18 may differentiatesimple steatosis from non-alcoholic steatohepatitis[J].World J Gastroenterol, 2007, 13 (6) :837-844. [13]CHEN J, ZHU Y, ZHENG Q, et al.Serum cytokeratin-18 in the diagnosis of non-alcoholicsteatohepatitis:a meta-analysis[J].Hepatol Res, 2014, 44 (8) :854-862. [14]GURTAN AM, SHARP PA.The role of miRNAs in regulating gene expression networks[J].J Mol Biol, 2013, 425 (19) :3582-3600. [15]PIROLA CJ, FERNNDEZ GIANOTTI T, CASTAO GO, et al.Circulating microRNA signature in non-alcoholic fatty liver disease:from serum non-coding RNAs to liver histology and disease pathogenesis[J].Gut, 2015, 64 (5) :800-812. [16]CERMELLI S, RUGGIERI A, MARRERO JA, et al.Circulating microRNAs in patients with chronic hepatitis C andnon-alcoholic fatty liver disease[J].PLo S One, 2011, 6 (8) :e23937. [17]TARANTINO G, CONCA P, PASANISI F, et al.Could inflammatory markers help diagnosenonalcoholic steatohepatitis?[J].Eur JGastroenterol Hepatol, 2009, 21 (5) :504-511. [18]YONEDA M, NOZAKI Y, ENDO H, et al.Serum ferritin is a clinical biomarker in Japanese patients with nonalcoholic steatohepatitis (NASH) independent of HFE gene mutation[J].Dig Dis Sci, 2010, 55 (3) :808-814. [19]KOWDLEY KV, BELT P, WILSON LA, et al.Serum ferritin is an independent predictor of histologic severity and advanced fibrosis in patients with nonalcoholic fatty liver disease[J].Hepatology, 2012, 55 (1) :77-85. [20]YONEDA M, UCHIYAMA T, KATO S, et al.Plasma Pentraxin3 is a novel marker for nonalcoholic steatohepatitis (NASH) [J].BMCGastroenterol, 2008, 8 (1) :53. [21]BOGA S, KOKSAL AR, ALKIM H, et al.Plasma Pentraxin 3 differentiates nonalcoholic steatohepatitis (NASH) from non-NASH[J].Metab Syndr Relat Disord, 2015, 13 (9) :393-399. [22]POYNARD T, RATZIU V, CHARLOTTE F, et al.Diagnostic value of biochemical markers (Nash Test) for the prediction of nonalcoholic steatohepatitis in patients with non-alcoholic fatty liver disease[J].BMC Gastroenterol, 2006, 6:34. [23]POYNARD T, LASSAILLY G, DIAZ E, et al.Performance of biomarkers Fibro Test, Acti Test, Steato Test, and Nash Test in patients with severe obesity:meta analysis of individual patient data[J].PLo S One, 2012, 7 (3) :e30325. [24]HARRISON SA, OLIVER D, ARNOLD HL, et al.Development and validation of a simple NAFLD clinical scoring system for identifying patients without advanced disease[J].Gut, 2008, 57 (10) :1441-1447. [25]RASZEJA-WYSZOMIRSKA J, SZYMANIK B, AWNICZAK M, et al.Validation of the BARD scoring system in Polish patients with nonalcoholic fatty liver disease (NAFLD) [J].BMC Gastroenterol, 2010, 10:67. [26]LEE TH, HAN SH, YANG JD, et al.Prediction of advanced fibrosis in nonalcoholic fatty liver disease:an enhanced model of BARDscore[J].Gut Liver, 2013, 7 (3) :323-328.
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