BibTex RIS Kaynak Göster

Non-Invasive Indirect Biochemical Markers for Liver Fibrosis

Yıl 2014, Cilt: 23 Sayı: 3, 427 - 442, 30.10.2014
https://doi.org/10.17827/aktd.51029

Öz

Liver fibrosis may be due to a variety of chronic liver diseases and may occur as a result of the healing process of liver damage. Although liver biopsy is accepted as the gold standard method in diagnosis and follow-up of patients with fibrosis currently, due to the serious complications like severe pain, internal bleeding, pneumothorax, and rarely death and even fault in the diagnostic accuracy like sampling error, various assessments by different pathologists and even by the same pathologist, interest in alternative methods is increasing day by day. In the light of these improvements, many studies have been performed on indirect non-invasive biochemical markers that can be used instead of liver biopsy, in the last decade. APRI, Forns index, FIB-4, AST-ALT ratio, age-platelet index, hepascore, fibrotest, fibroindex, fibrometer and fibrosis index are the most commonly used ones of these tests. While having some advantages like ease of accessibility, low complication rate, and lower costs, these tests cannot be used as the gold standard method due to the unsatisfactory diagnostic accuracy values. However, these indices have a high diagnostic value especially in the diagnosis and exclusion of significant fibrosis (METAVIR F2-4) and cirrhosis (METAVIR F4).

Kaynakça

  • Carey E, Carey WD. Noninvasive tests for liver disease, fibrosis, and cirrhosis: Is liver biopsy obsolete? Cleve Clin J Med. 2010;77:519-27.
  • Baranova A, Lal P, Birerdinc A, Younossi ZM. Non-invasive markers for hepatic fibrosis. BMC Gastroenterol. 2011;11:91.
  • Fontana L, Jerez D, Rojas-Valencia L, Solis-Herruzo JA, Greenwel P, Rojkind M. Ethanol induces the expression of alpha1(I) procollagen mRNA in a co-culture system containing a liver stellate cell-line and freshly isolated hepatocytes. Biochim Biophys Acta. 1997;1362:135-44.
  • Lin W, Wu G, Li S, Weinberg EM, Kumthip K, Peng LF et al. HIV and HCV cooperatively promote hepatic fibrogenesis via induction of reactive oxygen species and NF{kappa}B. J Biol Chem. 2011;286:2665-74.
  • Purohit V, Brenner DA. Mechanisms of Alcohol-Induced Hepatic Fibrosis: A Summary of the Ron Thurman Symposium. Hepatology. 2006;43:872-8.
  • Bataller R, Brenner DA. Liver Fibrosis. J Clin Invest. 2005;115:209-18.
  • McCuskey RS. Anatomy of the liver. In Zakim end Boyer’s hepatology: A Textbook of Liver Disease. Hepatology, 5th ed (Boyer TD, Wright TL, Manns MP): 3-21. Philadelphia, W.B. Sounders Company, 2006.
  • Friedman SL. Hepatic fibrosis: overview. Toxicology. 2008;254:120-9.
  • Schiff ER, Lee SS, Chao YC, Kew Yoon S, Bessone F, Wu SS et al. Long-term treatment with entecavir induces reversal of advanced fibrosis or cirrhosis in patients with chronic hepatitis B. Clin Gastroenterol Hepatol. 2011;9:274-6.
  • Chang TT, Liaw YF, Wu SS, Schiff E, Han KH, Lai CL et al. Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B. Hepatology. 2010;52:886-93.
  • Bravo A, Sheth SG, Chopra S. Liver biopsy. N Eng J Med. 2001;344:495-500.
  • Garcia-Tsao G, Boyer JL. Outpatient liver biopsy: how safe is it? Ann Intern Med. 1993;118:150-3. Campbell MS, Reddy KR. The evolving role of liver biopsy. Aliment Pharmacol Ther. 2004;20:249

Karaciğer Fibrozisinin İnvazif Olmayan Dolaylı Biyokimyasal Belirteçleri

Yıl 2014, Cilt: 23 Sayı: 3, 427 - 442, 30.10.2014
https://doi.org/10.17827/aktd.51029

Öz

Karaciğer fibrozisi karaciğerin çeşitli kronik hastalıklarına bağlı olarak ve karaciğer hasarının iyileşme sürecinin bir sonucu olarak gelişebilir. Hastalardaki fibrozisin tanı ve takibinde günümüzde kullanılan altın standart metot karaciğer biyopsisi olarak kabul görmekle birlikte şiddetli ağrı, kanama, pnömotoraks ve hatta ölüm gibi çok ciddi komplikasyonlara neden olabildiği ve örnekleme hatası, farklı patolog ve hatta aynı patolog tarafından farklı değerlendirmelerin yapılabilmesi gibi tanısal doğruluk sapmalarından dolayı alternatif tanı ve takip yöntemlerine yönelim gün geçtikçe artmıştır. Bu gelişmeler ışığında son on yılda karaciğer biyopsisi yerine kullanılabilecek invazif olmayan dolaylı biyokimyasal belirteçler üzerine çok sayıda araştırma yapılmıştır. APRI, Forns indeks, FIB-4, AST-ALT oranı, yaş-platelet indeksi, hepaskor, fibrotest, fibroindeks, fibrometre ve fibrozis indeksi bu testlerden en çok kullanılanlarıdır. Bu testler kolay ulaşılabilirlik, düşük maliyet ve minimum komplikasyon riskleri gibi avantajlara sahip olsa da ortalama tanısal doğruluk değerlerinin istenen düzeyde olmaması nedeni ile altın standart test olarak kullanılabilmeleri şu an için mümkün değildir. Ancak özellikle belirgin fibrozis (METAVIR F2-4) ve sirozun (METAVIR F4) tanısı ve dışlanmasında bu indekslerin tanısal değeri yüksektir.

Kaynakça

  • Carey E, Carey WD. Noninvasive tests for liver disease, fibrosis, and cirrhosis: Is liver biopsy obsolete? Cleve Clin J Med. 2010;77:519-27.
  • Baranova A, Lal P, Birerdinc A, Younossi ZM. Non-invasive markers for hepatic fibrosis. BMC Gastroenterol. 2011;11:91.
  • Fontana L, Jerez D, Rojas-Valencia L, Solis-Herruzo JA, Greenwel P, Rojkind M. Ethanol induces the expression of alpha1(I) procollagen mRNA in a co-culture system containing a liver stellate cell-line and freshly isolated hepatocytes. Biochim Biophys Acta. 1997;1362:135-44.
  • Lin W, Wu G, Li S, Weinberg EM, Kumthip K, Peng LF et al. HIV and HCV cooperatively promote hepatic fibrogenesis via induction of reactive oxygen species and NF{kappa}B. J Biol Chem. 2011;286:2665-74.
  • Purohit V, Brenner DA. Mechanisms of Alcohol-Induced Hepatic Fibrosis: A Summary of the Ron Thurman Symposium. Hepatology. 2006;43:872-8.
  • Bataller R, Brenner DA. Liver Fibrosis. J Clin Invest. 2005;115:209-18.
  • McCuskey RS. Anatomy of the liver. In Zakim end Boyer’s hepatology: A Textbook of Liver Disease. Hepatology, 5th ed (Boyer TD, Wright TL, Manns MP): 3-21. Philadelphia, W.B. Sounders Company, 2006.
  • Friedman SL. Hepatic fibrosis: overview. Toxicology. 2008;254:120-9.
  • Schiff ER, Lee SS, Chao YC, Kew Yoon S, Bessone F, Wu SS et al. Long-term treatment with entecavir induces reversal of advanced fibrosis or cirrhosis in patients with chronic hepatitis B. Clin Gastroenterol Hepatol. 2011;9:274-6.
  • Chang TT, Liaw YF, Wu SS, Schiff E, Han KH, Lai CL et al. Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B. Hepatology. 2010;52:886-93.
  • Bravo A, Sheth SG, Chopra S. Liver biopsy. N Eng J Med. 2001;344:495-500.
  • Garcia-Tsao G, Boyer JL. Outpatient liver biopsy: how safe is it? Ann Intern Med. 1993;118:150-3. Campbell MS, Reddy KR. The evolving role of liver biopsy. Aliment Pharmacol Ther. 2004;20:249
Toplam 12 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Derleme
Yazarlar

Hüseyin Kayadibi Bu kişi benim

Erdim Sertoğlu Bu kişi benim

Yayımlanma Tarihi 30 Ekim 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 23 Sayı: 3

Kaynak Göster

AMA Kayadibi H, Sertoğlu E. Karaciğer Fibrozisinin İnvazif Olmayan Dolaylı Biyokimyasal Belirteçleri. aktd. Eylül 2014;23(3):427-442. doi:10.17827/aktd.51029