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Vol. 150. Issue 8.
Pages 310-316 (April 2018)
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Vol. 150. Issue 8.
Pages 310-316 (April 2018)
Review
Markers of hepatic fibrosis
Marcadores de fibrosis hepática
Visits
8
Llorenç Caballeríaa,b,
Corresponding author
lcaballeria.bnm.ics@gencat.net

Corresponding author.
, Pere Torána,b, Joan Caballeríab,c
a Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Barcelona, Spain
b Servei d’Hepatologia, Hospital Clínic, Barcelona, Spain
c Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain
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Tables (4)
Table 1. Serological tests most used in clinical practice.
Table 2. Imaging tests in the diagnosis of liver fibrosis.
Table 3. Elastographic tests in the diagnosis of liver fibrosis.
Table 4. Early detection of liver fibrosis in the general population.
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Abstract

Chronic liver diseases constitute a major health problem. Chronic liver inflammation, defined by the degree of hepatic fibrosis, is asymptomatic in a significant percentage of patients; hence, the disease often remains undiagnosed until it has reached very advanced phases and, frequently, when the damage is irreversible. Ideally, patients should be screened during the initial phases of chronic inflammation, thus allowing for the effective management of the natural evolution of the disease by stopping or delaying its course. Standard diagnostic methods (transaminase determination or abdominal ultrasonography) do not allow for the early diagnosis of the degree of fibrosis. A liver biopsy is the invasive method of choice to screen for fibrosis, however, due to its limitations, non-invasive diagnostic methods such as elastography or serological markers are increasingly used as a good alternative for the early diagnosis of the degree of fibrosis.

Keywords:
Hepatic fibrosis
Abdominal ultrasonography
Liver biopsy
Hepatic elastography
Serological markers
Resumen

Las enfermedades hepáticas crónicas constituyen un importante problema de salud. La inflamación crónica del hígado, definida por el grado de fibrosis hepática, es asintomática en un porcentaje importante de pacientes, lo que determina que el diagnóstico de la enfermedad no se haga hasta fases muy avanzadas y muchas veces en situación de irreversibilidad. Lo ideal es identificar a los pacientes en fases iníciales de la inflamación crónica, lo cual permitirá incidir de manera efectiva en su historia natural, y detener o retrasar su evolución. Los métodos diagnósticos habituales (determinación de transaminasas o ecografía abdominal) no permiten diagnosticar precozmente el grado de fibrosis. La biopsia hepática es el método invasivo de referencia para la detección de fibrosis, sin embargo, debido a sus limitaciones, cada vez más se utilizan los métodos diagnósticos no invasivos, ya sean elastográficos o marcadores serológicos, constituyendo una buena alternativa para la detección precoz del grado de fibrosis.

Palabras clave:
Fibrosis hepática
Ecografía abdominal
Biopsia hepática
Elastografía hepática
Marcadores serológicos

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