Article information
Resumen
La biopsia hepática ha sido desde hace tiempo el patrón de referencia para evaluar el estado de la enfermedad hepática en pacientes con hepatitis C crónica. Aunque se sigue recomendando, este método se está cambiando por 2 motivos fundamentales: a) el tratamiento es más efectivo, y b) las pruebas bioquímicas y los test serológicos aportan mucha información sobre el estado de la enfermedad. Los patólogos pueden aumentar la relevancia y la utilidad de la biopsia hepática en la hepatitis C crónica, informando no sólo del estadio de la fibrosis y la actividad necroinflamatoria, sino también del grado de esteatosis y la acumulación de hierro, que están implicados en la progresión de la enfermedad. Además, pueden identificar otras enfermedades, como la esteatohepatitis y la hemocromatosis hereditaria. No obstante, con la utilización de los test serológicos se reducirán las indicaciones de la biopsia hepática.
For several years, liver biopsy has been the established gold standard for evaluating the status of liver disease in patients with chronic hepatitis C. Although this procedure continues to be recommended, current practice is changing for 2 main reasons: firstly, treatment is more effective and, secondly, biochemical and serological tests provide a great deal of information on disease progression. Pathologists can increase the importance and utility of liver biopsy in chronic hepatitis C, providing information not only on the stage of fibrosis and necroinflammatory activity but also on the grade of steatosis and iron accumulation, which are implicated in disease progression. Moreover, these specialists can identify other diseases, such as steatohepatitis and hereditary hemochromatosis. Nevertheless, the use of serological tests will reduce the indications for liver biopsy.
Full text is only aviable in PDF
Bibliografía
[1.]
G. García, E.B. Keeffe.
Liver biopsy in chronic hepatitis C: routine or selective.
Am J Gastroenterol, 96 (2001), pp. 3053-3055
[2.]
J.B. Wong, W.G. Bennett, R.S. Koff, S.G. Pauker.
Pretreatment evaluation of chronic hepatitis C. Risk, benefits and costs.
JAMA, 280 (1998), pp. 2088-2093
[3.]
A.A. Bravo, S.G. Sheth, S. Chopra.
Liver biopsy.
N Engl J Med, 344 (2001), pp. 495-500
[4.]
F. Piccinino, E. Sagnelli, G. Pasquale, G. Giusti.
Complications following percutaneous liver biopsy. A multicentre retrospective study on 68276 biopsies.
J Hepatol, 2 (1986), pp. 165-173
[5.]
W. Mayoral, J.H. Lewis.
Percutaneus liver biopsy. What is the current approach? Results of a questionnaire survey.
Dig Dis Sci, 46 (2001), pp. 118-127
[6.]
A. Regev, M. Berho, L.J. Jeffers, C. Milikowski, E.G. Molina, N.T. Pyrsopoulos, et al.
Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection.
Am J Gastroenterol, 97 (2002), pp. 2614-2618
[7.]
T. Poynard, J. McHutchison, M. Manns, R.P. Myers, J. Albrecht.
Biochemical surrogate markers of liver fibrosis and activity in a randomized trial of peginterferon alfa-2b and ribavirin.
Hepatology, 38 (2003), pp. 481-492
[8.]
G. Colloredo, M. Guido, A. Sonzogni, G. Leandro.
Impact of liver biopsy size on histological evaluation of chronic viral hepatitis: the smaller the sample, the milder the disease.
J Hepatol, 39 (2003), pp. 239-244
[9.]
P. Bedossa, D. Dargère, V. Paradis.
Sampling variability of liver fibrosis in chronic hepatitis C.
Hepatology, 38 (2003), pp. 1449-1457
[10.]
C. Spycher, A. Zimmermann, J. Reichen.
The diagnostic value of liver biopsy.
BMC Gastroenterology, 1 (2001), pp. 12
[11.]
N.Z. Afdhal.
Diagnosing fibrosis in hepatitis C: Is the pendulum swinging from biopsy to blood test?.
Hepatology, 37 (2003), pp. 972-974
[12.]
S.K. Herrine, L.S. Friedman.
Divining the role of liver biopsy in hepatitis C.
J Hepatol, 43 (2005), pp. 374-376
[13.]
L. Fartoux, O. Chazouillères, D. Wendum, R. Poupon, L. Serfaty.
Impact of steatosis in progression of fibrosis in patients with mild hepatitis C.
Hepatology, 41 (2005), pp. 82-87
[14.]
A.M. Di Bisciglie, H.L. Bonkovsky, S. Chopra, S. Flamin, R.K. Reddy, N. Grace, et al.
Iron reduction as an adjuvant to interferon therapy in patients wiht chronic hepatitis C who have previously not responded to interferon: a multicenter, prospective, randomized, controlled trial.
Hepatology, 32 (2000), pp. 135-138
[15.]
J.A. Solís Herruzo.
Indicaciones actuales de la biopsia hepática.
Rev Esp Enferm Dig, 98 (2006), pp. 122-139
[16.]
National Institutes of Health.
Consensus development conference panel statement. Management of hepatitis C.
Hepatology, 26 (1997), pp. 5S-10S
[17.]
French Consensus Conference. Treatment of hepatitis C. Recommendations. Paris, February 2002. Med Sci. 2002; 18:375-82.
[18.]
National Institutes of Health. Consensus Development Conference Statement. Management of hepatitis C. Hepatology 2002, June 10-12. Hepatology. 2002; 36 Suppl 1:3-20.
[19.]
E. Ubiña, R. Méndez, F. Rivera, N. Vera, G. Fernández, J.M. García, et al.
Biopsia hepática en pacientes con infección crónica por el VHC: experiencia de un hospital comarcal.
Gastroenterol Hepatol, 29 (2006), pp. 443-446
[20.]
E. Brunetti, E. Silini, A. Pistorio, A. Cavallero, A. Marangio, R. Bruno, et al.
Coarse vs. fine needle aspiration biopsy for the assessment of diffuse liver disease from hepatitis C virus-related chronic hepatitis.
J Hepatol, 40 (2004), pp. 501-506
[21.]
S. Brillante, M. Folli, S. Gaiani, C. Masci, M. Migloli, L. Barbara.
Persistent hepatitis C viraemia without liver disease.
Lancet, 341 (1993), pp. 464-465
[22.]
M.G. Ghany, D.E. Kleiner, H. Alter, et al.
Progression of fibrosis in chronic hepatitis C.
Gastroenterology, 124 (2003), pp. 97-104
[23.]
P. Pradat, A. Alberti, T. Poynard, J.I. Esteban, O. Weiland, P. Marcelin, et al.
Predictive value of ALT levels for histologic findings in chronic hepatitis C: a European collaborative study.
Hepatology, 36 (2002), pp. 973-977
[24.]
J. Crespo.
El arte de la predicción de la fibrosis en la hepatitis C.
Rev Esp Enf Dig, 98 (2006), pp. 157-160
[25.]
M. Ziol, A. Handra-Luca, A. Kettaneh, C. Christidis, F. Mal, F. Kazemi, et al.
Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C.
Hepatology, 41 (2005), pp. 48-54
[26.]
L. Castera, J. Vergniol, J. Foucher, B. Le Bail, E. Chanteloup, M. Haaser, et al.
Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C.
Gastroenterology, 128 (2005), pp. 343-350
[27.]
M. Kawamoto, T. Mizuguchi, T. Katsuramaki, M. Nagayama, H. Oshima, H. Kawasaki, et al.
Assessment of liver fibrosis by a noninvasive method of transient elastography and biochemical markers.
World J Gastroenterol, 12 (2006), pp. 4325-4330
[28.]
M. Romero Gómez, E. Gómez González, M. Vera Valencia, et al.
Fibrosis assessment in hepatitis C by computer-performed optical analysis of CT of the liver: a novel non-invasive and useful method.
J Hepatol, 42 (2005), pp. 218A
[29.]
M. Romera, R. Corpas, M. Romero Gómez.
La resistencia a la insulina en la valoración no invasiva de la fibrosis en pacientes con hepatitis C. Estudio comparativo de métodos bioquímicos.
Rev Esp Enf Dig, 98 (2006), pp. 161-169
[30.]
C.T. Wai, J.K. Greenson, R.J. Fontana, J.D. Kalbfleisch, J.A. Marrero, H.S. Conjeevaram, et al.
A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C.
Hepatology, 38 (2003), pp. 518-526
[31.]
X. Forns, S. Ampurdanés, J.M. Llovet, J. Aponte, L. Quinto, E. Martínez-Bauer, et al.
Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive model.
Hepatology, 36 (2002), pp. 986-992
[32.]
F. Imbert-Bismut, V. Ratziu, L. Pieroni, F. Charlotte, Y. Benhamou, T. Poynard, et al.
Biochemical markers of liver fibrosis in patients with hepatitis C virus infection: a prospective study.
Lancet, 357 (2001), pp. 1069-1075
[33.]
M. Romero Gómez, M. Ramírez.
Evaluación crítica de los métodos de estimación de la fibrosis en la hepatitis C crónica.
GH Continuada, 5 (2006), pp. 129-131
[34.]
K. Patel, S.C. Gordon, I. Jacobson, C. Hézode, E. Oh, K.M. Smith, et al.
Evaluation of a panel of non-invasive serum markers to differentiate mild from moderate-to-advanced liver fibrosis in chronic hepatitis C patients.
J Hepatol, 41 (2004), pp. 935-942
[35.]
M. Moreno, R. Pérez-Álvarez, L. Rodrigo, R. Pérez-López, M. González.
Evolución a largo plazo de la lesión hepática en pacientes con hepatitis crónica C y respuesta sostenida al tratamiento antiviral.
Rev Esp Enf Dig, 97 (2005), pp. 860-869
[36.]
T. Poynard, J. McHutchison, M. Manns, C. Trepo, K. Lindsay, Z. Goodman, et al.
Impact of pegylated interferon alfa-2b and ribavirin on liver fibrosis in patients with chronic hepatitis C.
Gastroenterology, 122 (2002), pp. 1303-1313
[37.]
E. Martínez-Bauer, J. Crespo, M. Romero-Gómez, R. Moreno-Otero, R. Solá, N. Teser, et al.
Development and validation of simple scoring models for early prediction of response to antiviral therapy in genotype 1 chronic hepatitis C.
Hepatology, 43 (2006), pp. 72-80
[38.]
P. Bedossa, P. Bioulac-Sage, P. Callard, M. Chevalier, C. Degott, Y. Deugnier, por el French METAVIR Cooperative Study Group, et al.
Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C.
Hepatology, 20 (1994), pp. 15-20
[39.]
B. Maharaj, R.J. Maharaj, W.P. Leary, R.M. Cooppan, A.D. Naran, D. Pirie, et al.
Sampling variability and its influence on the diagnostic yield of percutaneous needle biopsy of the liver.
Lancet, 8480 (1986), pp. 523-525
[40.]
Y. Saitou, K. Shiraki, Y. Yamanaka, Y. Yamaguchi, T. Kawakita, N. Yamamoto, et al.
Noninvasive estimation of liver fibrosis and response to interferon therapy by a serum fibrogenesis marker, YKL-40, in patients with HCV-associated liver disease.
World J Gastroenterol, 11 (2005), pp. 476-481
[41.]
D.E. Kleiner.
The liver biopsy inchronic hepatitis C: a view fron de other side of the microscope.
Semin Liver Dis, 25 (2005), pp. 52-64
[42.]
G. Sebastiani, A. Alberti.
Non invasive fibrosis biomarkers reduce but not substitute the need for liver biopsy.
World J Gastroenterol, 12 (2006), pp. 3682-3694
[43.]
E.B. Keefe, N.H. Afdhal, M.L. Shiffman, M.A. Edward King, M.A. Craig, L. Highleyman.
Debate: are noninvasive tests ready to replace liver biopsy?.
Clinical Care Options, LLC, (2006),
Copyright © 2007. Elsevier España S.L.. Todos los derechos reservados
