Biopsy and non-invasive methods for the diagnosis of liver fibrosis: does it take two to tango?

摘要: The birth of Hepatology as a defined clinical discipline coincides with the introduction Menghini's needle in late 1950s.1 In those days, very little was known about aetiology liver disease and majority patients diagnosis mainly based on morphological examination specimens obtained biopsy. Features such necrosis, inflammation fibrosis were not precisely categorised, final label merely descriptive—that is, chronic persistent, active hepatitis cirrhosis. these terms, biopsy only available diagnostic means, truly represented gold standard. so-called ‘one second liver’ characterised since beginning by significant cooperative effort between clinician pathologist. Clinical hepatologists trained pathology this led to foundation main academic schools Europe USA. The scoring systems step forward use This implied necessity for more precision evaluation that beyond description and, many instances, opinion Overall, supposed facilitate comparison samples communication results according global agreement. However, obvious advantage, once analysed statistical studies, started be criticised term reproducibility, intraobserver interobserver agreement, etc. For other reasons (sampling error, lack standards, etc.), value standard become questionable clinicians. These issues quite evident when used assess extent progression terms fibrotic transformation tissue, even …