The relationship between liver disease stage and liver fibrosis: a tangled web.
Summary of "The relationship between liver disease stage and liver fibrosis: a tangled web."
Germani G, Burroughs A K & Dhillon A P (2010) Histopathology The relationship between liver disease stage and liver fibrosis: a tangled web The structural consequences of chronic liver disease are described as a series of liver disease 'stages' with scarring and architectural change that eventually destroys and replaces the normal lobular structure of the liver. Fibrosis ('excess collagen') and stage have been confused in histological staging systems. Fibrosis is part of increasing liver disease stage, but fibrosis and stage are different. Staging liver disease is important in routine histopathological assessment. Measurement of liver fibrosis is another process. The collagenous proportion of a liver biopsy [collagen proportionate area (CPA)] correlates with hepatic venous pressure gradient (HVPG), which is of recognized prognostic value. CPA at 1 year post-transplantation in hepatitis C virus-infected patients predicts subsequent clinical decompensation. CPA in cirrhotic patients predicts decompensation more accurately than staging or HVPG. The 'cirrhosis' stage category has poor prognostic power, and CPA effectively substages cirrhosis. CPA improves the description of liver disease stage. Proper validation of antifibrotic treatments and 'non-invasive markers of liver fibrosis' requires measurement of liver fibrosis (and not liver biopsy stage scores). It is unacceptable for the words 'fibrosis' and 'score' to remain next to each other. There are benefits to properly understanding liver fibrosis and liver disease stage and properly assessing each of them.
Affiliation
The Royal Free Sheila Sherlock Liver Centre and University Department of Surgery UCL, Royal Free Hospital.
Journal Details
This article was published in the following journal.
Name: Histopathology
ISSN: 1365-2559
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20812954
- DOI: http://dx.doi.org/10.1111/j.1365-2559.2010.03609.x
Medical and Biotech [MESH] Definitions
End Stage Liver Disease
Final stage of a liver disease when the liver failure is irreversible and LIVER TRANSPLANTATION is needed.
Hepatolenticular Degeneration
A rare autosomal recessive disease characterized by the deposition of copper in the BRAIN; LIVER; CORNEA; and other organs. It is caused by defects in the ATP7B gene encoding copper-transporting ATPase 2 (EC 3.6.3.4), also known as the Wilson disease protein. The overload of copper inevitably leads to progressive liver and neurological dysfunction such as LIVER CIRRHOSIS; TREMOR; ATAXIA and intellectual deterioration. Hepatic dysfunction may precede neurologic dysfunction by several years.
Liver Cirrhosis, Experimental
Experimentally induced chronic injuries to the parenchymal cells in the liver to achieve a model for LIVER CIRRHOSIS.
Liver Cirrhosis
Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules.
Drug-induced Liver Injury
A spectrum of clinical liver diseases ranging from mild biochemical abnormalities to ACUTE LIVER FAILURE, caused by drugs, drug metabolites, and chemicals from the environment.
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