期刊
CLINICAL AND EXPERIMENTAL MEDICINE
卷 23, 期 2, 页码 273-285出版社
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s10238-022-00799-z
关键词
Liver biopsy; Ishak; METAVIR; Batts-Ludwig; Alcoholic hepatitis histology score (AHHS); NAFLD activity score (NAS); MAFLD; Repeat biopsy
This review emphasizes the importance of liver biopsy in evaluating chronic liver disease (CLD) and explains the commonly used scoring systems. It also discusses the utility of liver biopsy in examining alcohol-related liver disease, non-alcoholic fatty liver disease, viral hepatitis, haemochromatosis, and hepatocellular carcinoma.
The world-wide increase in chronic liver disease (CLD) calls for refinement of diagnostic and prognostic measures for early and accurate disease detection and management. Regardless of the aetiology, liver biopsy allows direct visualisation of specimen under the microscope. It facilitates histological evaluation of disease-specific morphological alterations. Thereby, it aids in disease diagnosis, prognosis, and assessment of treatment compliance/response. Indeed, with the advent of non-invasive methods, liver biopsy is used less frequently than before, but it is still considered as a gold standard for staging and grading several CLDs. This short review revisits liver biopsy. It highlights the significance of liver biopsy in evaluating CLDs and explains the commonly used Ishak, METAVIR and Batts-Ludwig scoring systems for grading and staging CLDs. The utility of liver biopsy in examining alcohol-related liver disease and non-alcoholic fatty liver disease (NAFLD) is discussed along with the disease-specific alcoholic hepatitis histology score (AHHS) and non-alcoholic fatty liver disease activity score (NAS). Additionally, the review elaborates on the role of liver biopsy in evaluating viral hepatitis, haemochromatosis, and hepatocellular carcinoma. Contextual explanation on the diagnosis of metabolic dysfunction-associated liver disease (MAFLD) is provided. The significance and clinical indications of repeat biopsy are also explained. Lastly, caveats and limitations associated with liver biopsy are reviewed. Essentially, this review collates the application of liver biopsy in assessing various CLDs and provides succinct explanations of the core scoring systems, all under one roof. It is clinically relevant and provides a useful synopsis to budding scientists and hepato-pathologists.
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