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Grading and staging of hepatic fibrosis, and its relationship with noninvasive
diagnostic parameters
#MMPMID14606100
Lu LG
; Zeng MD
; Wan MB
; Li CZ
; Mao YM
; Li JQ
; Qiu DK
; Cao AP
; Ye J
; Cai X
; Chen CW
; Wang JY
; Wu SM
; Zhu JS
; Zhou XQ
World J Gastroenterol
2003[Nov]; 9
(11
): 2574-8
PMID14606100
show ga
AIM: To explore the grade and stage of pathology and the relationship between
grading and staging of hepatic fibrosis and noninvasive diagnostic parameters.
METHODS: Inflammatory activity and fibrosis of consecutive liver biopsies from
200 patients with chronic liver disease were determined according to the
Diagnostic Criteria of Chronic Hepatitis in China, 1995. A comparative analysis
was made in these patients comparing serum markers, Doppler ultrasonography, CT
and/or MR imaging with the findings of liver biopsy. RESULTS: With increase of
inflammatory activity, the degree of fibrosis also rose. There was a close
correlation between liver fibrosis and inflammatory activity. AST, GGT, albumin,
albumin/globulin, ALP, AFP, hyaluronic acid, N-terminal procollagen III(P III
NP), collagen type IV(Col IV), tissue inhibitors of metalloproteinases-1
(TIMP-1), alpha-2-macroglobulin, natural killer cells(NK), some parameters of
Doppler ultrasonography, CT and/or MR imaging were all related to the degree of
inflammatory activity. GGT, albumin, albumin/globulin, ALP, AFP, hyaluronic acid,
Col IV, TIMP-1, alpha-2- macroglobulin, transforming growth factor-beta 1
(TGFbeta1), NK, some parameters of Doppler ultrasonography, CT and/or MR imaging
were all related to the staging of fibrosis. By regression analysis, the
parameters used in combination to differentiate the presence or absence of
fibrosis were age, GGT, the parameter of blood flow of portal vein per minute,
the maximum oblique diameter of right liver by B ultrasound, the wavy hepatic
surface contour by CT and/or MR. The sensitivity, specificity and accuracy of the
above parameters were 80.36%, 86.67%, and 81.10%, respectively. CONCLUSION: There
is close correlation between liver fibrosis and inflammatory activity. The
grading and staging of liver fibrosis are related to serum markers, Doppler
ultrasonography, CT and/or MR imaging. The combination of the above mentioned
noninvasive parameters are quite sensitive and specific in the diagnosis of
hepatic fibrosis.
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