Methods for non-invasive determination of advancement of liver fibrosis

Aim - to develop the method of non-invasive determination of liver fibrosis in patients with chronic hepatitis С. Materials and methods. 446 patients with chronic HCV infection (aged from 18 to 65 years; male -52.3%; female - 47.7%) were comprehensively surveyed. The linear discriminant analysis with the exception of discriminatory variables used by the all registered laboratory and ultrasound indicators, as well as the age of patients was performed. The results of the survey of 223 patients were used to create the discriminant model and the results of a survey of the remaining 223 patients, were used for the testing of the accuracy of the received discrimination. Conclusion. The discriminant model for noninvasive determination of the degree of liver fibrosis in patients with chronic hepatitis C with high sensitivity - 88.0% and specificity is 96.2% is developed.

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CHANGES IN CONCENTRATION OF SERUM FIBROSIS DIRECT BIOMARKERS IN CHRONIC LIVER DISEASES IN CHILDREN

PEDIATRIA Journal named after G N SPERANSKY ◽

10.24110/0031-403x-2021-100-2-112-118 ◽

2021 ◽

Vol 100 (2) ◽

pp. 112-118

Author(s):

E.A. Kulebina ◽

◽

A.N. Surkov ◽

N.M. Alyabeva ◽

I.V. Zubkova ◽

...

Keyword(s):

Liver Fibrosis ◽

Blood Serum ◽

Liver Diseases ◽

Chronic Liver ◽

Type I ◽

Chronic Liver Diseases ◽

Non Invasive ◽

Study Characteristics ◽

A Prospective Study

It is assumed that serum concentrations of type I, III, IV collagen (Col I, Col III, Col IV) and hyaluronic acid (HA) can provide informative evidence for the diagnosis of liver fibrosis (LF) using non-invasive procedures, however, there is insufficient data on the subject in paediatrics. Objectives: to study characteristics of changes in concentrations of Col I, Col III, Col IV and HA in blood serum in accordance with the stages of liver fibrosis in children. Materials and methods of research: a prospective study was carried out, which included 80 patients aged 5 to 17 years with chronic liver diseases of various etiologies, who underwent marginal resection of liver tissue under laparoscopic control, then a morphological study of the obtained biopsy was performed with determination of the stage of fibrosis on the METAVIR scale and the content of Col I, Col III, Col IV and HA in blood serum by the method of enzyme immunoassay. Results: the assessment of the content of K-I in the blood serum allows differentiating the stage F1 and F3 from F4 (p=0,025, p=0,006), Col IV – F1 from F2 (p=0,011), F3 (p=0,002) and F4 (p<0,001), HA – F1 from F3 (p=0,041), and also F4 from F1 (p<0,001), F2 (p<0,001) and F3 (p<0,001). There were no statistically significant differences in the content of Col III at different stages of LF (p=0,061). Statistically significant correlations of the histological stage of LF with changes in serological levels of Col I (ρ=–0,267, p=0,023), Col IV (ρ=0,409, p<0,001), and HA (ρ=0,575, p<0,001), and also the relationship between the concentrations of Col IV and HA (ρ=0,265, p=0,023). Conclusions: the correlations found in the histological phase of LF with changes in serological levels of Col I, Col IV and HA lead to the conclusion that fibrosis direct biomarkers are of diagnostic importance in determining the stage of LF, which is of great importance for practical medicine, especially in pediatrics.

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Diagnosis of liver fibrosis: an emphasis on elastography

Experimental and Clinical Gastroenterology ◽

10.31146/1682-8658-ecg-194-10-72-81 ◽

2021 ◽

pp. 72-81

Author(s):

I. I. Zhirkov ◽

A. V. Gordienko ◽

I. M. Pavlovich ◽

B. A. Chumak ◽

V. V. Yakovlev

Keyword(s):

Liver Fibrosis ◽

Liver Biopsy ◽

Initial Examination ◽

Morphological Examination ◽

Advantages And Disadvantages ◽

Non Invasive ◽

Combined Use ◽

Liver Elastography ◽

Diagnostic Capabilities

In the strategy of managing patients with chronic diffuse liver diseases, the priority areas are the determination of the diagnosis with the determination of the main risk factors, the activity of the process (steatosis, steatohepatitis), as well as the degree of fibrous transformation. The rate of progression of liver fibrosis is a decisive factor that will determine the prognosis, treatment tactics and the likelihood of severe complications. The “gold standard” for diagnosing chronic liver pathology is a puncture liver biopsy with morphological examination of the liver tissue. At the same time, potential complications, contraindications to the procedure, low patient compliance, as well as errors in the interpretation of the results obtained due to various reasons are significant limitations of this diagnostic method. These shortcomings were the reason for the search for reliable non-invasive methods for diagnosing liver fibrosis both during the initial examination and during subsequent monitoring in dynamics. Modern methods of liver elastography are widely used for non-invasive assessment of fibrosis, demonstrating good diagnostic capabilities and significantly reducing the need for liver biopsy. Various elastography methods, which have their own advantages and disadvantages, effectively complement each other, which is successfully used in clinical practice in the diagnosis of fibrous transformation. The combined use of elastographic methods and commercial predictive diagnostic panels will increase the diagnostic accuracy in the determination of liver fibrosis.

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