Evolving strategies for liver fibrosis staging: The non-invasive assessment

Abstract

Transient elastography and the acoustic radiation force impulse techniques may play a pivotal role in the study of liver fibrosis. Some studies have shown that elastography can detect both the progression and regression of fibrosis. Similarly, research results have been analysed and direct and indirect serum markers of hepatic fibrosis have shown high diagnostic accuracy for advanced fibrosis/cirrhosis. The prognosis of different stages of cirrhosis is well established and various staging systems have been proposed, largely based on clinical data. However, it is still unknown if either non-invasive markers of liver fibrosis or elastography may contribute to a more accurate staging of liver cirrhosis, in terms of prognosis and fibrosis regression after effective therapy. In fact, not enough studies have shown both the fibrosis regression in different cirrhosis stages and the point beyond which the prognosis does not change - even in the event of fibrosis regression. Therefore, future studies are needed to validate non-invasive methods in predicting the different phases of liver cirrhosis.

Predictive value of the albumin-bilirubin grade on long-term outcomes of CT-guided percutaneous microwave ablation in intrahepatic cholangiocarcinoma

“…Although CT-PMWA is a kind of minimal invasive therapies, preoperative hepatic function reserve was significantly associated with the long-term prognosis of patients. Our findings were consistent with previous studies [18][19][20][21][22][23][24][25][26]. Therefore, the better patients' hepatic function reserve was assessed, the better patients' prognosis could be evaluated.…”

“…The Child-Pugh classification system is widespread used to assess hepatic function reserve [18][19][20], but the subjective factors such as severity of ascites and degree of hepatic encephalopathy usually affect the assessment ability. Comparing to the Child-Pugh class, the albumin-bilirubin (ALBI) grade is associated with two important characteristics, which are simple and objective.…”

Liver Maximum Capacity: A Novel Test to Accurately Diagnose Different Stages of Liver Fibrosis

“…There is solid evidence supporting the fact that liver fibrosis is potentially reversible as long as a certain "point of no return" is not exceeded. Therefore, it is of fundamental importance to diagnose and assess the severity of liver fibrosis in order to permit risk stratification and provide appropriate management for preventing ongoing liver injury and cirrhosis [9,10].…”

Is serum angiotensin converting enzyme level a useful non-invasive marker for liver fibrosis in patients with chronic hepatitis C?

“…10 Also, there is an increasing number of ongoing studies for this purpose. 22 Measuring serum ACE levels is one of them, showing promising results in early studies, although some paradoxical outcomes have also been reported recently. [16][17][18]23 The issue of non--invasive methods has increasingly attracted many researchers, and frequently new studies on the topic are added to the literature.…”