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慢性肝病的组织学评分系统

Author
Maria Isabel Fiel, MD, FAASLD
Section Editor
Sanjiv Chopra, MD, MACP
Deputy Editor
Anne C Travis, MD, MSc, FACG, AGAF
Translators
汪志军, 主治医师

引言

慢性肝病的组织学评分系统被用于描述疾病进展的特征并预测疾病进展、判定预后、指导治疗策略以及提供临床试验中的标准。

本专题将总结慢性肝病的主要组织学评分系统。肝活检标本的一般解读和获取肝活检标本的方法将在别处讨论。 (参见“肝活检样本的解读”和“经皮肝活检、细针抽吸肝活检和腹腔镜肝活检”和“经颈静脉肝活组织检查”)

肝活检的局限性

肝活检用于评估肝病有一些局限性，包括：

●肝活检标本的质量参差不齐—长度小于2cm的标本可能难于解读。口径更大的穿刺针获取的标本，比细针抽吸活检获取的标本可能质量更好[1,2]。例如，小标本可能低估病毒性肝炎患者中炎症活动及纤维化的程度[3]。

●采样变异性–肝脏的组织学评估，通常是基于经皮穿刺活检，所采集的标本是一块非常小(1/50,000)的肝脏[4]。而肝脏疾病并不总是以同质的模式累及肝脏，导致可能存在抽样变异性。出现采样误差最常见的情况是肝硬化的肝脏[4]。

              

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Literature review current through: 2017-06 . | This topic last updated: 2015-01-30.
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