无创评估NAFLD肝纤维化的研究及其与肝细胞癌的相关性

Noninvasive evaluation of fibrosis in patients with NAFLD and its correlation with hepatocellular carcinoma

非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)疾病谱包括非酒精性肝脂肪变、非酒精性脂肪性肝炎(non-alcoholic steatohepatitis,NASH)、肝硬化和肝细胞癌(hepatocellular carcinoma,HCC)。肝纤维化是NAFLD进展为肝硬化及HCC的重要阶段,早期诊断肝纤维化程度对预后尤为重要。由于肝活检的有创性、并发症、重复率低及取样误差等局限性,近年来出现了多项评估肝纤维化的无创方法,主要包括多种血清学模型和影像学检查等。一些无创方法不仅可以评估肝纤维化程度,也能预测NAFLD患者HCC发病情况。本文就无创评估NAFLD肝纤维化的研究及其与HCC的相关性作一概述。

The disease spectrum of non-alcoholic fatty liver disease(NAFLD)includes non-alcoholic hepatic steatosis,non-alcoholic steatohepatitis(NASH),cirrhosis,and hepatocellular carcinoma(HCC).Fibrosis is an important stage in the progression of NAFLD to cirrhosis and HCC,and early diagnosis of the degree of fibrosis is especially important for prognosis.Because of the limitations of liver biopsy,such as invasiveness,complications,low repetition rate and sampling error,many noninvasive methods for evaluating liver fibrosis have appeared in recent years,including many kinds of serological models and imaging examinations.Some noninvasive methods can not only assess the degree of liver fibrosis,but also predict the incidence of HCC in patients with NAFLD.This article reviewed the noninvasive evaluation of fibrosis in patients with NAFLD and its correlation with HCC.