[Assessment of hepatic fibrosis]

Diagnosis of liver diseases is mainly based on histological criteria, therefore, liver biopsy uses to provide a final diagnosis in most of the cases. However, this procedure is associated with a risk of morbidity and morality, hence, a non-invasive method of assessing liver features would be helpful. Many serological tests have been used to assess degree of liver fibrosis, however, none of them has demonstrated to be specific enough for fibrosis. This is the case of the aminoterminal procollagen type III propeptide, the monovalent Fab fragment of antibodies against procollagen III or measurement of laminin P1 or fragments 7S and NC1 of type IV collagen. High serum levels of these markers are usually found in chronic active liver disease, however, these levels seems to be more closely related with inflammatory activity and fibrogenesis than with the degree of fibrosis. More recently, attention has been focused on the physical characterization of liver tissue by using ultrasound, nuclear magnetic resonance or spectroscopy. Although, none of these new methods has proved to be useful in assessing liver fibrosis sofar, we should hope that future improvements may allow better non-invasive quantification of liver fibrosis.