肝纤维化和肝硬化逆转的组织学评价

郑永见; 汪艳

doi:10.3969/j.issn.1001-5256.2019.04.002

肝纤维化和肝硬化逆转的组织学评价

DOI: 10.3969/j.issn.1001-5256.2019.04.002

郑永见,
汪艳

器官衰竭防治国家重点实验室广东省肝纤维化工程技术研究中心南方医科大学肝病研究所

基金项目:

国家自然科学基金(81670522)；广州市科技计划项目(201607020019)；

详细信息

中图分类号: R575.2
计量
- 文章访问数: 2007
- HTML全文浏览量: 37
- PDF下载量: 489
- 被引次数: 0
出版历程
- 收稿日期: 2019-01-02
- 出版日期: 2019-04-20

Histological assessment of reversal of liver fibrosis and cirrhosis

State Key Laboratory of Organ Failure Research, Guangdong Provincial Research Center for Liver Fibrosis, Institute of Hepatology, Southern Medical University, Central Laboratory of Southern Medical University, Southern Medical University

Research funding:

摘要

摘要: 肝纤维化的诊断为慢性肝病的治疗决策和预后评价等提供了重要依据。随着治疗学的飞速进步,各类新的临床问题纷纷涌现,对肝纤维化诊断技术的需求也不断更新。目前多数情况下,组织学评价仍是慢性肝病肝纤维化和肝硬化明确诊断的最可靠方式。基于主要临床文献数据,分析和讨论了组织学评价在当前慢性肝病管理和临床研究中诊断肝纤维化/肝硬化及其逆转的应用价值及研发方向。
- 肝硬化 /
- 肝炎,慢性 /
- 脂肪肝 /
- 组织学
Abstract: Liver fibrogenesis is a common pathway of pathological progression of chronic liver injuries. The diagnosis of liver fibrosis provides an important basis for treatment decision-making and prognostic evaluation of chronic liver diseases. With the rapid development of therapeutics, many new clinical issues have emerged, which requires new techniques for the diagnosis of liver fibrosis. At present, histological assessment remains the most reliable method for a definite diagnosis of liver fibrosis and cirrhosis. With reference to related clinical articles and data, this article analyzes the clinical value and research directions of histological assessment in chronic liver disease management and diagnosis of liver fibrosis/cirrhosis and its reversal.
- liver cirrhosis /
- hepatitis, chronic /
- fatty liver /
- histology

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参考文献(48)

[1]BEDOSSA P. Reversibility of hepatitis B virus cirrhosis after therapy:Who and why?[J]. Liver Int, 2015, 35 (Suppl 1) :78-81.

[2]POYNARD T, BEDOSSA P, OPOLON P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. The OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC groups[J].Lancet, 1997, 349 (9055) :825-832.

[3]POYNARD T, MOUSSALLI J, MUNTEANU M, et al. Slow regression of liver fibrosis presumed by repeated biomarkers after virological cure in patients with chronic hepatitis C[J]. J Hepatol, 2013, 59 (4) :675-683.

[4]LIU Z, WEI X, CHEN T, et al. Characterization of fibrosis changes in chronic hepatitis C patients after virological cure:A systematic review with meta-analysis[J]. J Gastroenterol Hepatol, 2017, 32 (3) :548-557.

[5]HOEFS JC, SHIFFMAN ML, GOODMAN ZD, et al. Rate of progression of hepatic fibrosis in patients with chronic hepatitis C:Results from the HALT-C Trial[J]. Gastroenterology, 2011, 141 (3) :900-908.

[6]Sh ILI S, GIOVANNA S, FOUCHER J, et al. Post-treatment liver stiffness measurement is not useful to predict hepatocellular carcinoma in HCV patients who achieve SVR[J]. J Hepatol, 2018, 68:s14.

[7]KANWAL F, KRAMER J, ASCH SM, et al. Risk of hepatocellular cancer in HCV patients treated with direct-acting antiviral agents[J]. Gastroenterology, 2017, 153 (4) :996-1005.

[8]PARK JW, CHEN M, COLOMBO M, et al. Global patterns of hepatocellular carcinoma management from diagnosis to death:The BRIDGE study[J]. Liver Int, 2015, 35 (9) :2155-2166.

[9]PAPATHEODORIDIS GV, DALEKOS G, YURDAYDIN C, et al.Prediction and need for surveillance of hepatocellular carcinoma (HCC) development after the first 5 years of entecavir (ETV) or tenofovir disoproxil fumarate therapy in caucasian chronic hepatitis B (CHB) patients of the PAGE-B cohort[J]. Hepatology, 2018, 68:11A-12A.

[10]BROUWER WP, van der MEER AJP, BOONSTRA A, et al.Prediction of long-term clinical outcome in a diverse chronic hepatitis B population:Role of the PAGE-B score[J]. J Viral Hepat, 2017, 24 (11) :1023-1031.

[11]GEORGE J, ANSTEE Q, RATZIU V, et al. NAFLD:The evolving landscape[J]. J Hepatol, 2018, 68 (2) :227-229.

[12]ADAMS LA, SANDERSON S, LINDOR KD, et al. The histological course of nonalcoholic fatty liver disease:A longitudinal study of 103 patients with sequential liver biopsies[J]. J Hepatol, 2005, 42 (1) :132-138.

[13]WONG VW, WONG GL, CHOI PC, et al. Disease progression of non-alcoholic fatty liver disease:A prospective study with paired liver biopsies at 3 years[J]. Gut, 2010, 59 (7) :969-974.

[14]McPHERSON S, HARDY T, HENDERSON E, et al. Evidence of NAFLD progression from steatosis to fibrosing-steatohepatitis using paired biopsies:Implications for prognosis and clinical management[J]. J Hepatol, 2015, 62 (5) :1148-1155.

[15]CHALASANI N, YOUNOSSI Z, LAVINE JE, et al. The diagnosis and management of nonalcoholic fatty liver disease:Practice guidance from the American Association for the Study of Liver Diseases[J]. Hepatology, 2018, 67 (1) :328-357.

[16]BRUNT EM, KLEINER DE, WILSON LA, et al. Improvements in histologic features and diagnosis associated with improvement in fibrosis in NASH:Results from the NASH clinical research network treatment trials[J]. Hepatology, 2018.[Epub ahead of print]

[17]ANGULO P, KLEINER DE, DAM-LARSEN S, et al. Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease[J]. Gastroenterology, 2015, 149 (2) :389-397.

[18]YOUNOSSI ZM, STEPANOVA M, RAFIQ N, et al. Pathologic criteria for nonalcoholic steatohepatitis:Interprotocol agreement and ability to predict liver-related mortality[J]. Hepatology, 2011, 53 (6) :1874-1882.

[19]BRUNT EM, BELT P, WILSON L, et al. Progression to bridging fibrosis in non-alcoholic fatty liver disease over 4 years in the NASH CRN[J]. Hepatology, 2013.[Epub ahead of print]

[20]COLLABORATORS GBDA. Alcohol use and burden for 195countries and territories, 1990-2016:A systematic analysis for the Global Burden of Disease Study 2016[J]. Lancet, 2018, 392 (10152) :1015-1035.

[21]MATHURIN P, BEUZIN F, LOUVET A, et al. Fibrosis progression occurs in a subgroup of heavy drinkers with typical histological features[J]. Aliment Pharmacol Ther, 2007, 25 (9) :1047-1054.

[22]SINGAL AK, BATALLER R, AHN J, et al. ACG clinical guideline:Alcoholic liver disease[J]. Am J Gastroenterol, 2018, 113 (2) :175-194.

[23]CRABB DW, BATALLER R, CHALASANI NP, et al. Standard definitions and common data elements for clinical trials in patients with alcoholic hepatitis:Recommendation from the NIAAA alcoholic hepatitis consortia[J]. Gastroenterology, 2016, 150 (4) :785-790.

[24]BATALLER R, GAO B. Liver fibrosis in alcoholic liver disease[J]. Semin Liver Dis, 2015, 35 (2) :146-156.

[25]SZABO G, KAMATH PS, SHAH VH, et al. Alcohol-related liver disease:Areas of consensus, unmet needs and opportunities for further study[J]. Hepatology, 2019.[Epub ahead of print]

[26]TAYLOR LE, SWAN T, MAYER KH. HIV coinfection with hepatitis C virus:Evolving epidemiology and treatment paradigms[J]. Clin Infect Dis, 2012, 55 (Suppl 1) :s33-s42.

[27]RAMESH S, SANYAL AJ. Hepatitis C and nonalcoholic fatty liver disease[J]. Semin Liver Dis, 2004, 24 (4) :399-413.

[28]BEDOSSA P, MOUCARI R, CHELBI E, et al. Evidence for a role of nonalcoholic steatohepatitis in hepatitis C:A prospective study[J]. Hepatology, 2007, 46 (2) :380-387.

[29]KNODELL RG, ISHAK KG, BLACK WC, et al. Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis[J]. Hepatology, 1981, 1 (5) :431-435.

[30]ISHAK K, BAPTISTA A, BIANCHI L, et al. Histological grading and staging of chronic hepatitis[J]. J Hepatol, 1995, 22 (6) :696-699.

[31]BATTS KP, LUDWIG J. Chronic hepatitis. An update on terminology and reporting[J]. Am J Surg Pathol, 1995, 19 (12) :1409-1417.

[32]BEDOSSA P, POYNARD T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group[J]. Hepatology, 1996, 24 (2) :289-293.

[33]KLEINER DE, BRUNT EM, van NATTA M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease[J]. Hepatology, 2005, 41 (6) :1313-1321.

[34]BEDOSSA P, CONSORTIUM FP. Utility and appropriateness of the fatty liver inhibition of progression (FLIP) algorithm and steatosis, activity, and fibrosis (SAF) score in the evaluation of biopsies of nonalcoholic fatty liver disease[J]. Hepatology, 2014, 60 (2) :565-575.

[35]WANLESS IR, SWEENEY G, DHILLON AP, et al. Lack of progressive hepatic fibrosis during long-term therapy with deferiprone in subjects with transfusion-dependent beta-thalassemia[J]. Blood, 2002, 100 (5) :1566-1569.

[36]KUMAR M, SAKHUJA P, KUMAR A, et al. Histological subclassification of cirrhosis based on histological-haemodynamic correlation[J]. Aliment Pharmacol Ther, 2008, 27 (9) :771-779.

[37]NAGULA S, JAIN D, GROSZMANN RJ, et al. Histologicalhemodynamic correlation in cirrhosis-a histological classification of the severity of cirrhosis[J]. J Hepatol, 2006, 44 (1) :111-117.

[38]JIMENEZ W, PARES A, CABALLERIA J, et al. Measurement of fibrosis in needle liver biopsies:Evaluation of a colorimetric method[J]. Hepatology, 1985, 5 (5) :815-818.

[39]O'BRIEN MJ, KEATING NM, ELDERINY S, et al. An assessment of digital image analysis to measure fibrosis in liver biopsy specimens of patients with chronic hepatitis C[J]. Am J Clin Pathol, 2000, 114 (5) :712-718.

[40]WANG Y, HOU JL. Fibrosis assessment:Impact on current management of chronic liver disease and application of quantitative invasive tools[J]. Hepatol Int, 2016, 10 (3) :448-461.

[41]ZIPFEL WR, WILLIAMS RM, WEBB WW. Nonlinear magic:Imultiphoton microscopy in the biosciences[J]. Nat Biotechnol, 2003, 21 (11) :1369-1377.

[42]PELLER J, FARAHI F, TRAMMELL SR. Hyperspectral imaging system based on a single-pixel camera design for detecting differences in tissue properties[J]. Appl Opt, 2018, 57 (27) :7651-7658.

[43]XU S, WANG Y, TAI DC, et al. qFibrosis:A fully-quantitative innovative method incorporating histological features to facilitate accurate fibrosis scoring in animal model and chronic hepatitis B patients[J]. J Hepatol, 2014, 61 (2) :260-269.

[44]WANG Y, VINCENT R, YANG J, et al. Dual-photon microscopy-based quantitation of fibrosis-related parameters (qFP) to model disease progression in steatohepatitis[J]. Hepatology, 2017, 65 (6) :1891-1903.

[45]WANG Y, HUANG W, LI R, et al. Systematic quantification of histological patterns shows accuracy in reflecting cirrhotic remodeling[J]. J Gastroenterol Hepatol, 2017, 32 (9) :1631-1639.

[46]WANG Y, LIANG X, YANG J, et al. Improved performance of quantitative collagen parameters versus standard histology in longitudinal assessment of nonadvanced liver fibrosis for chronic hepatitis B[J]. J Viral Hepat, 2018, 25 (5) :598-607.

[47]BEDOSSA P, GARCIA-TSAO G, JAIN D. Cirrhosis regression and subclassification[J]. Surg Pathol Clin, 2013, 6 (2) :295-309.

[48] SUN Y, ZHOU J, WANG L, et al. New classification of liver biopsy assessment for fibrosis in chronic hepatitis B patients before and after treatment[J]. Hepatology, 2017, 65 (5) :1438-1450.

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