Do we still need a liver biopsy? Are the serum fibrosis tests ready for prime time?
Liver biopsy has been in use for more than a century for diagnosis and staging of acute and chronic liver diseases. Several serum markers and panels offer the opportunity to assess the extent of liver disease noninvasively and spare some patients the risks associated with percutaneous liver biopsy, but only a few of the noninvasive serum markers allow the determination of different stages of fibrosis on a continuum similar to that achieved with liver biopsy. This article reviews the results of recent published and preliminary studies on serum markers, focusing on their comparison with liver biopsy and their clinical utility.
Crockett
Seth D
SD
Department of Medicine, Stanford University Medical Center, 750 Welch Road, Stanford, CA 94034, USA.
Kaltenbach
Tonya
T
Keeffe
Emmet B
EB
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D044963:Biopsy, Fine-Needle; D002784:Cholesterol / Q000097:blood; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology*; D010446:Peptide Fragments / Q000097:blood; D010976:Platelet Count; D011347:Procollagen / Q000097:blood; D011517:Prothrombin Time; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood
D010446:Peptide Fragments; D011347:Procollagen; D019715:Tissue Inhibitor of Metalloproteinase-1; C041876:procollagen Type III-N-terminal peptide; D002784:Cholesterol; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase