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Non-invasive Serum Markers of Fibrosis

  • Thomas Pembroke
  • Giada Sebastiani
Chapter

Abstract

Liver fibrosis occurs when a chronic injury of any etiology leads to excessive accumulation of extracellular matrix proteins in the hepatic parenchyma. Staging of liver fibrosis and subsequent identification of patients with liver cirrhosis and portal hypertension is pivotal for the management and prognostication of chronic liver diseases of any etiology. Liver biopsy and the measurement of hepatic venous pressure gradient through transjugular catheterization of hepatic vein have long been the gold standard of reference to diagnose hepatic cirrhosis and for detection of clinically significant portal hypertension, respectively. However, due to their cost and invasiveness, recent years have seen the development and implementation of non-invasive serum biomarkers. Some serum fibrosis biomarkers present with high accuracy for diagnosis of liver cirrhosis and monitoring of its related complications. Moreover, they demonstrate prognostic value to predict clinical outcomes deriving from portal hypertension complications. Serum fibrosis biomarkers have been gradually incorporated into clinical guidelines and are progressively becoming first-line diagnostic tests for liver cirrhosis, with significant reduction in the need for liver biopsy. We here provide an update on pathophysiological rationale on the diagnostic and prognostic application of serum fibrosis biomarkers and on their accuracy in clinical scenarios related to liver cirrhosis and its complications.

Keywords

Liver fibrosis Cirrhosis Portal hypertension Serum fibrosis biomarkers 

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Royal Victoria HospitalMcGill University Health CentreMontrealCanada
  2. 2.School of MedicineCardiff UniversityCardiffUK

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