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首页> 外文期刊>World journal of gastroenterology : >Limitations of liver biopsy and non-invasive diagnostic tests for the diagnosis of nonalcoholic fatty liver diseaseonalcoholic steatohepatitis
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Limitations of liver biopsy and non-invasive diagnostic tests for the diagnosis of nonalcoholic fatty liver diseaseonalcoholic steatohepatitis

机译:肝活检的局限性和用于非酒精性脂肪肝/非酒精性脂肪性肝炎的非侵入性诊断测试

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摘要

It is estimated that 30% of the adult population in Japan is affected by nonalcoholic fatty liver disease (NAFLD). Fatty changes of the liver are generally diagnosed using imaging methods such as abdominal ultrasonography (US) and computed tomography (CT), but the sensitivity of these imaging techniques is low in cases of mild steatosis. Alanine aminotransferase levels may be normal in some of these patients, warranting the necessity to establish a set of parameters useful for detecting NAFLD, and the more severe form of the disease, nonalcoholic steatohepatitis (NASH). Although liver biopsy is currently the gold standard for diagnosing progressive NASH, it has many drawbacks, such as sampling error, cost, and risk of complications. Furthermore, it is not realistic to perform liver biopsies on all NAFLD patients. Diagnosis of NASH using various biomarkers, scoring systems and imaging methods, such as elastography, has recently been attempted. The NAFIC score, calculated from the levels of ferritin, fasting insulin, and type. collagen 7S, is useful for the diagnosis of NASH, while the NAFLD fibrosis score and the FIB-4 index are useful for excluding NASH in cases of advanced fibrosis. This article reviews the limitations and merits of liver biopsy and noninvasive diagnostic tests in the diagnosis of NAFLD/NASH. (C) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.
机译:据估计,日本30%的成年人口患有非酒精性脂肪肝疾病(NAFLD)。通常使用腹部超声(US)和计算机断层扫描(CT)等影像学方法来诊断肝脏的脂肪变化,但是在轻度脂肪变性的情况下,这些影像学技术的敏感性较低。在这些患者中,某些患者的丙氨酸氨基转移酶水平可能是正常的,因此有必要建立一套可用于检测NAFLD的参数,以及更严重的非酒精性脂肪性肝炎(NASH)。尽管肝活检目前是诊断进行性NASH的金标准,但它有许多缺点,例如取样误差,成本和并发症风险。此外,对所有NAFLD患者进行肝活检是不现实的。最近尝试了使用各种生物标记,评分系统和成像方法(例如弹性成像)诊断NASH。根据铁蛋白,空腹胰岛素和类型的水平计算得出的NAFIC得分。胶原7S可用于诊断NASH,而NAFLD纤维化评分和FIB-4指数可用于排除晚期纤维化病例中的NASH。本文回顾了肝活检和无创诊断检查在NAFLD / NASH诊断中的局限性和优点。 (C)2014百事登出版集团有限公司。版权所有。

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