Non-Invasive Assessment of Liver Fibrosis Progression and Prognosis in Primary Biliary Cholangitis

被引:6
|
作者
Poupon, Raoul [1 ,2 ,3 ]
机构
[1] Hop St Antoine, AP HP, Serv Hepatol, FR-75571 Paris 12, France
[2] Hop St Antoine, AP HP, Ctr Reference Malad Inflammatoires Voies Biliaire, FR-75571 Paris 12, France
[3] Univ Paris 06, INSERM, UMR S, Paris, France
关键词
Fibrosis; Cirrhosis; Transient elastography; Primary biliary cholangitis; TREATED PATIENTS; CIRRHOSIS;
D O I
10.1159/000440758
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
PBC (formerly known as primary biliary cirrhosis and now named primary biliary cholangitis) is a disease with a wide range of severity and variable rate of progression. The diagnosis of advanced liver fibrosis/cirrhosis portends an increased risk of liver-related morbidity and mortality. Because of its invasiveness, liver biopsy tends to be replaced by non-invasive tools for assessing liver fibrosis, making prognosis and optimising risk stratification for selection of patients, requiring new medical approaches. Many direct or indirect biomarkers have been found to correlate with the severity of liver fibrosis in PBC. They are easy to use but lack sensitivity and reproducibility in individuals with early stage disease. Three main radiologic approaches are currently proposed to assess liver fibrosis: vibration controlled transient elastography (VCTE), acoustic radiation force impulse and magnetic resonance elastography. Data using VCTE are available only for the longitudinal evaluation of liver fibrosis and prognosis in PBC. VCTE outperformed all other non-invasive current surrogate markers of liver fibrosis in PBC. Because of its high acceptability and its ability to predict hepatic decompensation, VCTE could be a useful tool to help allocate cirrhotic patients into different categories of risk. None of the radiologic and serum markers have a perfect accuracy in studies so far published. Concordance between VCTE and serum biomarkers is a prerequisite for a correct prognosis assessment in individuals in clinical practice. (C) 2015 S. Karger AG, Basel
引用
收藏
页码:115 / 117
页数:3
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