血清标志物与瞬时弹性成像技术评估肝纤维化的研究进展

许峰铭; 盛庆寿

doi:10.3969/j.issn.1001-5256.2018.03.040

血清标志物与瞬时弹性成像技术评估肝纤维化的研究进展

DOI: 10.3969/j.issn.1001-5256.2018.03.040

1. 广西中医药大学
2. 广西中医药大学附属瑞康医院肝病科

基金项目:

国家“十二五”科技重大专项(2014ZX10005001)；广西科技厅课题(GZZX15-19)；

详细信息

中图分类号: R575.2
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出版历程
- 出版日期: 2018-03-20

Research advances in serum markers and transient elastography in the evaluation of liver fibrosis

Guangxi University of Chinese Medicine

Research funding:

摘要

摘要: 肝纤维化及部分早期肝硬化是可逆转的,及时准确地判断肝纤维化程度对慢性肝脏疾病的预防治疗及预后判断具有显著的临床意义。近年来,血清标志物及瞬时弹性成像技术在评估肝纤维化方面已取得较大的进展,介绍了血清学指标及其相关模型对肝纤维化的评估价值,如壳多糖酶3样蛋白1、GP模型、Forns、APRI和FIB-4指数;并简述了瞬时弹性成像检测技术在慢性肝病患者肝纤维化程度分期中的应用进展;认为二者的联合应用对肝纤维化程度的评估有较高的价值。
- 肝硬化 /
- 弹性成像技术 /
- 生物学标记 /
- 诊断 /
- 综述
Abstract: Studies have shown that liver fibrosis and some cases of early liver cirrhosis can be reversed, and thus a timely, accurate judgment of fibrosis degree has important clinical significance in prevention/treatment and prognostic evaluation of chronic liver diseases. In recent years, great achievements have been made in the application of serum markers and transient elastography for the evaluation of liver fibrosis. This article introduces the value of serological markers and related models in evaluating liver fibrosis, including CHI3 L1, GP model, Forns, APRI, and FIB-4 index, and reviews the advances in the application of transient elastography in determining fibrosis stage in patients with chronic liver diseases. It is pointed out that a combination of these two methods has a high value in evaluating fibrosis degree.
- liver cirrhosis /
- elasticity imaging techniques /
- biological markers /
- diagnosis /
- review

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参考文献(32)

[1]SCHIFF ER, MADDREY WC, SORREL MF.Schiff's diseases of the liver[M].11th Ed.Beijing:Peking University Medical Press, 2015:275.

[2]GUO R, YAN M.Research progress in mechanisms of cellular and molecular in liver fibrosis[J/CD].Chin J Liver Dis:Electron Edition, 2012, 4 (4) :57-62. (in Chinese) 郭蓉, 阎明.肝纤维化的细胞和分子机制研究进展[J/CD].中国肝脏病杂志:电子版, 2012, 4 (4) :57-62.

[3]YAO GB.Clinical hepatology[M].2th Ed.Shanghai:Shanghai Scientific and Technical Publishers, 2011:320. (in Chinese) 姚光弼.临床肝脏病学[M].第2版.上海:上海科学技术出版社, 2011:320.

[4]LIBREROS S, GARCIA-AREAS R, IRAGAVARAPU-CHARYULU V.CHI3L1 plays a role in cancer through enhanced production of proinflammatory/pro-tumorigenic and angiogenic factors[J].Immunol Res, 2013, 57 (1-3) :99-105.

[5]DEZSO Z, NIKOLSKY Y, SVIRIDOV E, et al.A comprehensive functional analysis of tissue specificity of human gene expression[J].BMC Biol, 2008, 6 (1) :49.

[6]MYERS RP, POMIERLAYRARGUES G, KIRSCH R, et al.Feasibility and diagnostic performance of the Fibro Scan XL probe for liver stiffness measurement in overweight and obese patients[J].Hepatology, 2012, 55 (1) :199-208.

[7]EURICH D, NEUMANN UP, BOASKNOOP S, et al.YKL-40-gene polymorphism affects acute cellular rejection and fibrosis progression after transplantation for hepatitis C virus-induced liver disease[J].J Gastroenterol Hepatol, 2013, 28 (1) :153-160.

[8]CAO X, GUAN YJ, CHEN MJ.Clinical analysis of serum YKL-40 level and liver fibrosis in patients with chronic hepatitis B virus infection[J].Chin Hepatol, 2016, 21 (1) :57-59. (in Chinese) 曹欣, 关玉娟, 陈美娟.慢性乙型肝炎病毒感染患者血清YKL-40水平与肝纤维化的临床分析[J].肝脏, 2016, 21 (1) :57-59.

[9]HUANG H, WU T, MAO J, et al.CHI3L1 is a liver-enriched, noninvasive biomarker that can be used to stage and diagnose substantial hepatic fibrosis[J].OMICS, 2015, 19 (6) :339-345.

[10]LEE CK, PEREZ-ATAYDE AR, MITCHELL PD, et al.Serum biomarkers and transient elastography as predictors of advanced liver fibrosis in a United States cohort:the Boston children's hospital experience[J].J Pediatr, 2013, 163 (4) :1058-1064.

[11]LIU XD, WU JL, LIANG J, et al.Globulin-platelet model predicts minimal fibrosis and cirrhosis in chronic hepatitis B virus infected patients[J].World J Gastroenterol, 2012, 18 (22) :2784-2792.

[12]LI Q, LU C, LI W, et al.Globulin-platelet model predicts significant fibrosis and cirrhosis in CHB patients with high HBV DNA and mildly elevated alanine transaminase levels[J].Clin Exp Med, 2017.[Epub ahead of print]

[13]LIN H, GAN LY, TU YY, et al.Comparison of APRI, FIB-4and GP models in the diagnosis and treatment of chronic hepatitis B cirrhosis[J].J Prac Med, 2016, 32 (24) :4076-4079. (in Chinese) 林海, 甘龙禹, 涂燕云, 等.APRI、FIB-4、GP模型对预测慢性乙肝肝硬化诊断及疗效的比较[J].实用医学杂志, 2016, 32 (24) :4076-4079.

[14]FORNS X, AMPURDANES S, LLOVET JM, et al.Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive model[J].Hepatology, 2002, 36 (4 Pt 1) :986-992.

[15]KAYADIBI H, YASAR B, OZKARA S, et al.The diagnostic accuracy of the Forns index, platelet count and AST to Platelet Ratio Index derived fibrosis index for the prediction of hepatitis C virus-related significant liver fibrosis and cirrhosis[J].Scand J Clin Lab Invest, 2014, 74 (3) :240-247.

[16]DONG DR, HAO MN, CHENG LI, et al.Acoustic radiation force impulse elastography, Fibro Scan, Forns'index and their combination in the assessment of liver fibrosis in patients with chronic hepatitis B, and the impact of inflammatory activity and steatosis on these diagnostic methods[J].Mol Med Rep, 2015, 11 (6) :4174-4182.

[17]WAI CT, GREENSON JK, FONTANA RJ, et al.A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C[J].Hepatology, 2003, 38 (2) :518-526.

[18]LIU J, LIU YX, DONG CF, et al.Noninvasive diagnosis of liver fibrosis in patients with chronic hepatitis B by ARFI, Forns index, FIB-4 and APRI[J/CD].Chin J Liver Dis:Electronic Edition, 2014 (1) :18-21. (in Chinese) 刘京, 刘映霞, 董常峰, 等.ARFI、Forns指数、FIB-4和APRI无创诊断慢性乙型病毒性肝炎肝纤维化的研究[J/CD].中国肝脏病杂志:电子版, 2014 (1) :18-21.

[19]WU FX, GAO BH, NIU CY, et al.Value of APRI score in the diagnosis and prediction of liver fibrosis in patients with chronic hepatitis B[J].J Clin Hepatol, 2017, 33 (8) :1483-1486. (in Chinese) 吴方雄, 高保华, 牛春燕, 等.APRI评分对慢性乙型肝炎肝纤维化程度的诊断及预测价值[J].临床肝胆病杂志, 2017, 33 (8) :1483-1486.

[20]WU SD, WANG JL.Staging of liver fibrosis in chronic hepatitis B patients with a composite predictive model:a comparative study[J].World J Gastroenterol, 2010, 16 (4) :501-507.

[21]CHENG JY, MA H.Research progress in noninvasive diagnosis of liver fibrosis in chronic liver disease[J].J Clin Hepatol, 2014, 30 (2) :178-181. (in Chinese) 程捷瑶, 马红.慢性肝病肝纤维化无创诊断的研究进展[J].临床肝胆病杂志, 2014, 30 (2) :178-181.

[22]STERLING RK, LISSEN E, CLUMECK N, et al.Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection[J].Hepatology, 2006, 43 (6) :1317-1325.

[23]HE LH, NIU ZL, YE Y.Value of FIB-4 and APRI index in evaluating the severity of liver fibrosis among patients with chronic hepatitis B[J].Int J Lab Med, 2017, 38 (15) :2076-2078. (in Chinese) 何丽华, 钮志林, 叶扬.FIB-4及APRI指数对慢性乙型肝炎患者肝纤维化严重程度的评估价值[J].国际检验医学杂志, 2017, 38 (15) :2076-2078.

[24]AHMAD W, IJAZ B, JAVED F T, et al.A comparison of four fibrosis indexes in chronic HCV:development of new fibrosis-cirrhosis index (FCI) [J].BMC Gastroenterol, 2011, 11:44.

[25]ABDOLLAHI M, POURI A, GHOJAZADEH M, et al.Non-invasive serum fibrosis markers:a study in chronic hepatitis[J].Bioimpacts, 2015, 5 (1) :17-23.

[26]HOUOT M, NGO Y, MUNTEANU M, et al.Systematic review with meta-analysis:direct comparisons of biomarkers for the diagnosis of fibrosis in chronic hepatitis C and B[J].Aliment Pharmacol Ther, 2016, 43 (1) :16-29.

[27]WEI H, WANG HM, GUO H.Value of Fibro Scan in early diagnosis of liver fibrosis in patients with chronic liver disease[J].Mod Dig Interv, 2017, 22 (3) :315-318. (in Chinese) 魏华, 王海梅, 郭何.Fibro Scan用于慢性肝病患者肝纤维化的早期诊断价值[J].现代消化及介入诊疗, 2017, 22 (3) :315-318.

[28]TAKEMOTO R, NAKAMUTA M, AOYAGI Y, et al.Validity of Fibro Scan values for predicting hepatic fibrosis stage in patients with chronic HCV infection[J].J Dig Dis, 2009, 10 (2) :145-148.

[29]DING HF, MA K, NING Q.Clinical significance of Fibroscan non-invasive detection of liver fibrosis in patients who are chronic hepatitis B virus carriers[J].Acta Med Univ Sci Technol Huazhong, 2015, 44 (5) :572-574. (in Chinese) 丁红方, 马科, 宁琴.Fibroscan无创检测慢性乙型肝炎病毒携带者肝纤维化的临床意义[J].华中科技大学学报:医学版, 2015, 44 (5) :572-574.

[30]LU Q, LU C, LI J, et al.Stiffness value and serum biomarkers in liver fibrosis staging:study in large surgical specimens in patients with chronic hepatitis B[J].Radiology, 2016, 280 (1) :290-299.

[31]WU LZ.Diagnostic value of transient elastography (Fibro Touch) for hepatic fibrosis in patients with chronic hepatitis B[D].Beijing:Capital Med Univ, 2016. (in Chinese) 吴灵芝.瞬时弹性成像技术 (Fibro Touch) 对慢性乙型肝炎肝纤维化的诊断价值[D].北京:首都医科大学, 2016.

[32]WU N, ZHANG MY, WU RH, et al.Comparative analysis of the diagnostic value of Fibro Scan and Fibro Touch for liver fibrosis[J].J Clin Hepatol, 2014, 30 (7) :624-627. (in Chinese) 吴娜, 张明媛, 吴瑞红, 等.Fibro Scan与Fibro Touch对肝纤维化程度诊断价值的比较分析[J].临床肝胆病杂志, 2014, 30 (7) :624-627.

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