对肝纤维化和肝硬化回归的审查
1Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA.
Journal of pathology and translational medicine
|July 18, 2023
概括
肝硬化曾经被认为是不可逆转的,现在被理解为一个动态的,双向的过程. 新的治疗方法显示纤维化回归,改善肝功能和存活率,但癌症风险仍然存在,需要监测.
科学领域:
- 肝病学和胃肠道学
- 纤维化和肝硬化研究
- 肝脏疾病的进展和回归
背景情况:
- 肝硬化传统上被视为一种不可逆转的末期肝病.
- 慢性肝病的新兴治疗方法挑战了这种不可逆转的范式.
- 纤维化和纤维化现在被认为是动态的,双向的过程.
研究的目的:
- 重新评估肝硬化的性质作为一个动态的,而不是静态的,条件.
- 为了突出肝纤维化的双向进展和回归.
- 强调这些发现对临床分类和患者管理的影响.
主要方法:
- 在纤维化进展和回归期间对肝脏组织的微观变化的审查.
- 分析临床参数,包括肝功能和血液动力学标志物.
- 将纤维化的双向性纳入北京分类系统.
主要成果:
- 纤维化和肝硬化的回归是可以通过现代治疗来实现的.
- 肝功能,血液动力学标志物和生存率的显著改善.
- 显微镜证据显示,肝脏结构发生了动态变化,包括肝细胞迁移和血管重塑.
结论:
- 肝硬化应该被认为是慢性肝病进化的动态阶段,而不是不可逆转的终点.
- 尽管回归,残留的血管病变和累积突变增加肝细胞癌的风险.
- 持续的临床监测对于患者至关重要,即使有纤维化回归的证据.
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