肝硬化逆转的组织病理学评价

Histopathological evaluation of cirrhosis reversal

正常肝脏在病因长期、反复刺激下均可发展为肝硬化,组织学表现为弥漫性肝纤维化伴肝小叶结构(包括微血管结构)塌陷、假小叶形成,进而引起门静脉高压,甚至出现失代偿肝硬化。越来越多的证据表明,有效的病因治疗不仅可以延缓肝硬化的进展,还可以逆转肝硬化。肝硬化逆转的机制主要包括细胞外基质的降解、肝细胞再生及肝小叶重构。目前,肝活检仍是肝硬化逆转评价的"金标准"。因此,肝硬化逆转的组织病理学评价对于判断疾病预后、疗效评价及机制探索均至关重要。

A normal liver can develop cirrhosis through long-term and repeated stimulation from various etiologies.Histological manifestations like the collapse of hepatic lobular structure(including microvascular structure)and the formation of pseudolobules can lead to portal hypertension and even decompensated cirrhosis.More and more evidence suggests that effective etiological treatment can not only delay but also reverse the progression of cirrhosis.The mechanism of cirrhosis reversal mainly includes the degradation of extracellular matrix,hepatocyte regeneration,and hepatic lobular remodeling.The"gold standard"for the evaluation of cirrhosis reversal at present is still a liver biopsy.Therefore,the histopathological evaluation of cirrhosis reversal is very important for determining the disease’s prognosis,efficacy,and mechanism of exploration.