Non-invasive assessment of chronic liver and gastric diseases

摘要: Abstract Background In patients with both chronic liver diseases and dyspepsia there is the need for non-invasive, inexpensive effective laboratory tests. These tests should not substitute but complement integrate information derived from invasive techniques such as biopsy esofagogastroduodenoscopy. Natural history studies indicate that advanced fibrosis cirrhosis develop in about 20%–40% of hepatitis B or C, a similar proportion those alcoholic non-alcoholic steatohepatitis. these patients, precise definition hepatic stage most important parameter to assess risk disease progression decide an immediate appropriate antiviral therapy. Methods Liver represents gold standard evaluating presence, type body evidence has been accumulated demonstrate limitations this technique, including inter- intra-observer variations, sampling errors variability. recent years increasing interest possibility identifying describing by using surrogate markers measurable blood. Many have dedicated evaluation “direct” fibrogenesis, while second approach based on single combined biochemical parameters reflect disease. Upper gastrointestinal symptoms are common developed countries makes impossible use esofagogastroduodenoscopy all dyspepsia. The Maastricht 2-2000 Consensus meeting suggested screening treating Helicobacter pylori infection dyspeptic primary health care first line therapy newly onset Conclusions Combination panels biomarkers demonstrated improve accuracy algorithms sequential combination non-invasive high diagnostic achieved fibrosis. This, turn, translates reduction > 50% taking biopsies. A panel which includes measurement serum pepsinogen I II, gastrin G-17 anti-H. antibodies gastric disease, due its negative predictive value, appears be valuable screen