Progress of non-invasive diagnostic of liver fibrosis: review of modern laboratory methods

Abstract

Fibrosis and cirrhosis are traditionally diagnosed by making a biopsy. However, in recent decades, scientists around the world have shown that the accepted “gold standard of diagnosis” – morphological assessment of biopsy – has a number of limitations. The search for non-invasive techniques to diagnose fibrosis has led to the development of many scales using laboratory indices. Non-invasive diagnostic techniques are safer for the patient than liver biopsy. In addition, they can be repeated in a dynamic to assess the condition of the liver over time. Most currently available non-invasive diagnostic techniques are considerably cheaper than the accepted “gold standard”. Their practical use is increasing every year, and in a number of countries the frequency of liver biopsies in viral hepatitis B and C is steadily decreasing due to the development of serum and imaging diagnostic systems. Recent studies show that the assessment of the degree of fibrosis by non-invasive methods is as accurate as a morphological study. In recent years, a number of serum markers have been considered as non-invasive diagnostics of the stages of liver fibrosis, among which the largest number of studies are devoted to hyaluronic acid, type IV collagen, and their combination with various common laboratory tests. The latest non-invasive techniques will make a significant paradigm shift in the evaluation of liver fibrosis in the near future. In this review we have analyzed widely used as well as experimental laboratory techniques used in the diagnosis of liver fibrosis.