title: Circulating markers of liver fibrosis progression.
abstract: BACKGROUND
  Fibrogenesis is a typical reaction of the liver to injury. In the case of overstimulation of fibrogenesis clinically significant fibrosis and, eventually, cirrhosis occur. Treatment of liver cirrhosis is limited, therefore it is important to screen and monitor patients at risk of cirrhosis. Noninvasive parameters are ideal for this purpose due to their risk profile and repeatability.
  
  
  METHODS
  Systematic review of literature.
  
  
  RESULTS
  Among large number of proposed biomarkers, there is a distinct difference between two groups or classes. Class I biomarkers are associated with the process of fibrogenesis, their presence in the serum is the result of the increased turnover of extracellular matrix. Class II biomarkers and their combinations are mostly markers of liver function or structural damage. We have identified 27 Class I and 13 Class II biomarkers that have been proposed in the literature. We have evaluated in detail those which reached limited clinical application.
  
  
  CONCLUSIONS
  General clinical acceptance of these biomarkers is low because of various drawbacks. Simple and readily available biomarkers have low accuracy in predicting liver fibrosis and more advanced markers have low cost-benefit ratio. Therefore liver biopsy remains the "gold standard" for diagnosis of fibrosis. However potential noninvasive alternatives exist and their implementation could be valuable.
authors.affiliation: 1st Department of Internal Medicine, P.J. Safárik University, Kosice, Slovakia. petjarc@yahoo.com
authors.forename: Peter
authors.initials: P
authors.lastname: Jarcuska
authors.forename: Martin
authors.initials: M
authors.lastname: Janicko
authors.forename: Eduard
authors.initials: E
authors.lastname: Veselíny
authors.forename: Pavol
authors.initials: P
authors.lastname: Jarcuska
authors.forename: Lubomír
authors.initials: L
authors.lastname: Skladaný
mesh_terms: D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology
chemical_list: D015415:Biomarkers