scholarly journals Role of liver biopsy versus non-invasive biomarkers for diagnosis of significant fibrosis and cirrhosis: a web-based survey

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mohamed Alboraie ◽  
Marwa Khairy ◽  
Aisha Elsharkawy ◽  
Noha Asem ◽  
Mohamed El Kassas ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Biopsy ◽  
Hepatic Fibrosis ◽  
Serum Biomarkers ◽  
Response To Treatment ◽  
Web Based ◽  
Non Invasive ◽  
Single Method ◽  
Radiological Methods

Abstract Background Liver biopsy is the standard reference for staging hepatic fibrosis. Non-invasive methods for assessment of hepatic fibrosis and cirrhosis are becoming increasingly popular. Objective We aimed at exploring the change in practice regarding the use of liver biopsy and non-invasive methods for staging hepatic fibrosis and cirrhosis among hepatologists. Methods We performed a survey-based study that recruited hepatologists from various Egyptian institutions. Physicians were deemed eligible if they had a degree in internal medicine with hepatology as a subspecialty. We utilized an online-based survey that assessed the acceptability and reliability of liver biopsy, serum biomarkers, and radiological tools for evaluating liver fibrosis and cirrhosis. Results A total of 573 responses were retrieved (response rate = 80.3%). Out of them, 58% were having more than 15 years of experience as a hepatologist. Liver biopsy is still considered the gold standard for assessment of hepatic fibrosis and cirrhosis by 61% of participants. Liver biopsy was accepted by 44% of their patients. 84% reported the need for a more practical alternative to liver biopsy to assess disease progression or response to treatment. 78.34% of participants know serum biomarkers, 84.08% reported that they were acceptable by their patients, 37.79% thought they are reliable. 95.4% were familiar with radiological methods of non-invasive assessment of hepatic fibrosis, 89.1% reported that radiological methods were acceptable by their patients, 62% think that they are reliable and 78% reported they were applicable in clinical practice. Sixty-five percent think that combining non-invasive methods is better than using a single method. Forty percent of participants thought that radiological methods are easier to use for assessment of hepatic fibrosis followed by a combination of non-invasive methods, serum biomarkers, and liver biopsy respectively. Conclusion In conclusion, liver biopsy is still considered the most reliable method for evaluation and staging of liver cirrhosis by hepatologists in Egyptian institutions, despite the modest acceptance by the patients. Nonetheless, non-invasive methods are gaining acceptance by Egyptian physicians and patients, and most of them consider these methods as reliable and applicable tools for predicting the course of liver cirrhosis.

scholarly journals The role of elastography in the assessment of chronic liver disease in children

2019 ◽  
Vol 19 (3) ◽  
pp. 2806-2311
Author(s):  
Süleyman Sönmez ◽  
Merve Boşat ◽  
Nihal Yurtseven ◽  
Eray Yurtseven
Keyword(s):  
Liver Disease ◽  
Liver Biopsy ◽  
Chronic Liver Disease ◽  
Real Time ◽  
Correlation Coefficient ◽  
Hepatic Fibrosis ◽  
Pearson Correlation ◽  
Chronic Liver ◽  
Liver Biopsies

Background: Conventional ultrasonography is a method preferred for the investigation of chronic liver diseases in pediatric groups, as it is non-invasive, cheap, feasible and available. The purpose of this study is to present the role of Share-wave Elastography (SWE) in terms of diagnostic value in children diagnosed with “chronic liver disease.”Methods: We studied patients who had been diagnosed with chronic liver disease between March 2012-September 2015, and who had undergone liver biopsy and had their pathology results, compared with 26 healthy subjects. Statistical analysis was performed with IBM SPSS Statistics for Windows, Version 20.0. “Pearson Correlation Analysis” was performed in order to measure the relationship between elastography values and Brunt level.Results: This study had 107 subjects in total, consisting of 81 patients between 0-204 months of age Pearson correlation coefficient level was determined as r = 0.644. Since the correlation coefficient is positive, there is a same-directional relationship between Elastography level and Brunt degree. This means that while one of the variables is increasing, the other one will also increase.Conclusion: Since it is known that development of hepatic fibrosis is a dynamic process, and that many hepatic fibrosis etiologies are known to continue throughout the course of life, the application of Real time SWE method instead of repeated liver biopsies on patients is a much simpler and smart method. Increasing the clinical use of Real Time SWE method with future studies might provide an opportunity for preventing unnecessary liver biopsies since the patients are evaluated in a shorter time and in a cost-effective manner.Keywords: Shear-Wave Elastography, Brunt degree, chronic liver disease, liver biopsy.

scholarly journals Toll-Like Receptor as a Potential Biomarker in Renal Diseases

2020 ◽  
Vol 21 (18) ◽  
pp. 6712
Author(s):  
Sebastian Mertowski ◽  
Paulina Lipa ◽  
Izabela Morawska ◽  
Paulina Niedźwiedzka-Rystwej ◽  
Dominika Bębnowska ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Immunoglobulin A ◽  
Response To Treatment ◽  
Renal Diseases ◽  
Toll Like Receptor ◽  
Progressive Development ◽  
Non Invasive ◽  
Potential Marker ◽  
Potential Biomarker

One of the major challenges faced by modern nephrology is the identification of biomarkers associated with histopathological patterns or defined pathogenic mechanisms that may assist in the non-invasive diagnosis of kidney disease, particularly glomerulopathy. The identification of such molecules may allow prognostic subgroups to be established based on the type of disease, thereby predicting response to treatment or disease relapse. Advances in understanding the pathogenesis of diseases, such as membranous nephropathy, minimal change disease, focal segmental glomerulosclerosis, IgA (immunoglobulin A) nephropathy, and diabetic nephropathy, along with the progressive development and standardization of plasma and urine proteomics techniques, have facilitated the identification of an increasing number of molecules that may be useful for these purposes. The growing number of studies on the role of TLR (toll-like receptor) receptors in the pathogenesis of kidney disease forces contemporary researchers to reflect on these molecules, which may soon join the group of renal biomarkers and become a helpful tool in the diagnosis of glomerulopathy. In this article, we conducted a thorough review of the literature on the role of TLRs in the pathogenesis of glomerulopathy. The role of TLR receptors as potential marker molecules for the development of neoplastic diseases is emphasized more and more often, as prognostic factors in diseases on several epidemiological backgrounds.

scholarly journals Role of Elastography in Early Detection of Liver Cirrhosis

2017 ◽  
Vol 1 (5) ◽  
Author(s):  
David Susanto ◽  
Visakha R Irawan
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Early Detection ◽  
Liver Biopsy ◽  
Invasive Procedure ◽  
Chronic Liver ◽  
Fibrotic Tissue ◽  
Long Duration

Liver cirrhosis is a condition in which the liver slowly deteriorates and is unable tofunction usually due to chronic, or long lasting, injury. Fibrotic tissue replaces healthy livertissue and partially blocks the flow of blood through the liver. Fibrosis increases liver stiffness.Liver palpation on the early physical examination has been used to assess liver stiffness.Though, palpation has some limitations, such as highly subjective, very operator dependent,and sometimes even impossible to perform. At present, liver biopsy remains the current goldstandard for assessing liver fibrosis, even though the diagnostic accuracy is limited by thespecimen size, invasive procedure, and long duration for getting the result. Elastography is analternative method to liver biopsy in patients with chronic liver disease.Keywords: chronic liver disease, elastography, liver cirrhosis

scholarly journals Value of hepatic elastography and Doppler indexes for predictions of esophageal varices in liver cirrhosis

2015 ◽  
Vol 17 (1) ◽  
pp. 5 ◽  
Author(s):  
Adriana Bintintan ◽  
Romeo Ioan Chira ◽  
Vasile Virgil Bintintan ◽  
Georgiana Nagy ◽  
Roberta Maria Manzat-Saplacan ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Esophageal Varices ◽  
Statistical Power ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Abdominal Ultrasound ◽  
Non Invasive ◽  
Cirrhotic Patients ◽  
Ultrasound Parameters

Aims: Non-invasive methods are required to diagnose presence and grading of esophageal varices in patients with he- patic cirrhosis and in this respect we have evaluated the role of transient elastography and abdominal ultrasound parameters. Material and methods: Cirrhotic patients were prospectively evaluated by transient elastography and Doppler ultrasound for diagnosis of presence and grading of esophageal varices, the results being compared with the findings of the esophagogas- troduodenoscopy. Results: Sixty patients with hepatic cirrhosis were analysed. The parameters that reached statistical signifi- cance for diagnosis of esophageal varices were: liver stiffness (LSM) > 15 kPa, hemodynamic liver index (PVr1) ≥ 0.66, portal vascular resistance (PVR) > 17.66 and splenoportal index (SPI) > 4.77. The only parameter that reached statistical power for the diagnosis of large esophageal varices was LSM at a cut-off value of 28.8 kPa. Conclusions: Assessment of LSM in patients with liver cirrhosis can predict both the presence of esophageal varices and of large esophageal varices. The PVr1, PVR and SPI Doppler indexes can be used to diagnose the presence of esophageal varices but have no role in the prediction of large esophageal varices. Further studies are required to confirm these results and offer a stronger clinical significance.

scholarly journals The role of genetic factors in the development of liver cirrhosis in viral hepatitis B/D

2016 ◽  
Vol 21 (4) ◽  
pp. 206-210
Author(s):  
Aziza S. Khikmatullaeva ◽  
E. I Musabaev
Keyword(s):  
Liver Cirrhosis ◽  
Genetic Factors ◽  
Research Study ◽  
Non Invasive ◽  
Disease Outcomes ◽  
Viral Hepatitis B ◽  
Traditional Risk Factors ◽  
Hdv Infection ◽  
The Impact

In the article there is presented the influence of genetic variation in the IL28B gene on the risk of the development of liver cirrhosis and possibility offorecasting disease outcomes of HB/DV infected patients. The purpose of the research: Study of the influence of genetic variations in the IL28V gene on the risk of the development of liver cirrhosis and the ability to forecast the disease outcome of HB/DV infected patients. Materials and methods: For the assessment of the impact of IL28Brs8099917 SNP among the observed groups there was determined the genotype of rs8099917 in the IL28B locus TaqMan SNP by means of genotyping of 94 persons, including 72 patients with liver cirrhosis associated with HDV infection. For the comparison, there was taken a group of 22 patients with liver cirrhosis of HBV etiology. Results of executed studies have shown the distribution of genotypes in liver cirrhosis of HBV etiology to be differed considerably from liver cirrhosis of HDV etiology, as for rs8099917 TT genotype (P < 0.001) as well in rs8099917 TG genotype (P < 0.001). Traditional risk factors for the liver cirrhosis (sex, age, viral load, comorbidities) hardly influenced on the outcome of chronic viral hepatitides. Results ofperformed studies have shown the distribution of genotypes with liver cirrhosis induced by HDV to be significantly differed from the liver cirrhosis of HBV etiology, as well of TT genotype as TG genotype. Conclusion: Thus, the genetic analysis is a promising method for the non-invasive diagnosis of risk for development of liver cirrhosis.

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