肝硬化血清标志物的研究进展.doc

肝硬化血清标志物的研究进展肝硬化血清标志物的研究进展首先, 诊断肝纤维化有很多血清标记物, 也就是说还没有金指标。有很多血清标记物意味着还没有真正的标记物, 实际上这些血清标记物是用于将严重纤维化、肝硬化与其他疾病区分开来的。 Hans Van Vlierberghe 比利时根特大学医院 Hepatology Digest: Liver biopsy is an invasive test. Therefore, the use of non-invasive serum biomarkers has been developed for diagnosis of liver fibrosis. What are some things we need to be mindful of when we use these biomarkers ina clinical setting? Prof. Van Vlieberghe: First of all, there are a lot of biomarkers for establishing liver fibrosis, which means the Holy Grail is not there yet. There are a lot of seromarkers so the real one is not there. What those seromarkers are actually doing is distinguishing severe fibrosis and cirrhosis versus the rest. If you use them in these conditions then it is ok. If you want them to distinguish, for example, between an F2 and an F3 on the METAVIR score, then it won't work very well. So, if you expect this from a biomarker you will lose. I think that biomarkers can be implemented in clinics ina way where bine, for example two biomarkers. If the two biomarkers are concordant, if they say there is the same degree of fibrosis, if there is less fibrosis then you can wait and not perform a biopsy, if the biomarkers say there is cirrhosis, you don't need the biopsy and you have to follow-up for HCC and variceal bleeding, and in the gray zone between F0 and F4, then you can decide on what to do. Y