中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 3
Mar.  2023
Turn off MathJax
Article Contents

Thinking of the pathological diagnosis of unexplained liver cirrhosis

DOI: 10.3969/j.issn.1001-5256.2023.03.003
Research funding:

Jiangsu Commission of Health (ZD2021061)

More Information
  • Corresponding author: YANG Yongfeng, yyf1997@163.com (ORCID: 0000-0002-3214-0038)
  • Received Date: 2023-01-16
  • Accepted Date: 2023-02-20
  • Published Date: 2023-03-20
  • Liver cirrhosis is the final stage of various chronic liver diseases, and the common etiologies of liver cirrhosis include chronic viral hepatitis, nonalcoholic fatty liver disease, autoimmune liver diseases, and inherited metabolic liver disease. An accurate etiological diagnosis is an important prerequisite for etiological treatment. Unexplained liver cirrhosis refers to liver cirrhosis without a definite etiology after medical history inquiry, physical examination, and auxiliary examination. At present, liver histopathological examination is a gold standard for the diagnosis of liver cirrhosis and an important basis for exploring the etiology of liver cirrhosis. It may help with the etiological diagnosis of unexplained liver cirrhosis to evaluate the pattern of liver fibrosis, the type of inflammatory injury, and related pathological changes with reference to a comprehensive analysis of related medical history, signs, laboratory examination, and radiological examination. This article reviews the pathological features and diagnostic thinking of unexplained liver cirrhosis.

     

  • loading
  • [1]
    GINÈS P, KRAG A, ABRALDES JG, et al. Liver cirrhosis[J]. Lancet, 2021, 398(10308): 1359-1376. DOI: 10.1016/S0140-6736(21)01374-X.
    [2]
    Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Consensus on the diagnosis and therapy of hepatic fibrosis(2019)[J]. J Clin Hepatol, 2019, 35(10): 2163-2172. DOI: 10.3969/j.issn.1001-5256.2019.10.007.

    中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会. 肝纤维化诊断及治疗共识(2019年)[J]. 临床肝胆病杂志, 2019, 35(10): 2163-2172. DOI: 10.3969/j.issn.1001-5256.2019.10.007.
    [3]
    KRISHNA M. Histological grading and staging of chronic hepatitis[J]. Clin Liver Dis (Hoboken), 2021, 17(4): 222-226. DOI: 10.1002/cld.1014.
    [4]
    KIM MY, CHO MY, BAIK SK, et al. Histological subclassification of cirrhosis using the Laennec fibrosis scoring system correlates with clinical stage and grade of portal hypertension[J]. J Hepatol, 2011, 55(5): 1004-1009. DOI: 10.1016/j.jhep.2011.02.012.
    [5]
    SUN Y, ZHOU J, WANG L, et al. New classification of liver biopsy assessment for fibrosis in chronic hepatitis B patients before and after treatment[J]. Hepatology, 2017, 65(5): 1438-1450. DOI: 10.1002/hep.29009.
    [6]
    Chinese Society of Hepatology, Chinese Medical Association. Chinese guidelines on the management of liver cirrhosis[J]. J Clin Hepatol, 2019, 35(11): 2408-2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006.

    中华医学会肝病学分会. 肝硬化诊治指南[J]. 临床肝胆病杂志, 2019, 35(11): 2408-2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006.
    [7]
    PATEL N, SHARMA B, SAMANT H. Gryptogenic cirrhosis[M]. Treasure Island(FL): Statpearls Publishing, 2022.
    [8]
    MASIOR Ł, GRT M, KRASNODBSKI M, et al. Liver transplantation in patients with cryptogenic cirrhosis provides excellent long-term outcome[J]. Ann Transplant, 2016, 21: 160-166. DOI: 10.12659/aot.894686.
    [9]
    TARDU A, KARAGUL S, YAGCI MA, et al. Histopathological examination of explanted liver after transplantation in patients with cryptogenic cirrhosis[J]. Transplant Proc, 2015, 47(5): 1450-1452. DOI: 10.1016/j.transproceed.2015.04.020.
    [10]
    AYATA G, GORDON FD, LEWIS WD, et al. Cryptogenic cirrhosis: clinicopathologic findings at and after liver transplantation[J]. Hum Pathol, 2002, 33(11): 1098-1104. DOI: 10.1053/hupa.2002.129419.
    [11]
    NALBANTOGLU I, JAIN D. Cryptogenic cirrhosis: Old and new perspectives in the era of molecular and genomic medicine[J]. Semin Diagn Pathol, 2019, 36(6): 389-394. DOI: 10.1053/j.semdp.2019.07.003.
    [12]
    ZHANG F, ZHANG ZY. Etiology and clinical characteristics of patients with cirrhosis in 763 cases[J]. Chin J Clin Gastroenterol, 2019, 31(2): 89-92. DOI: 10.3870/lcxh.j.issn.1005-541X.2019.02.05.

    张飞, 张志勇. 763例肝硬化患者的病因及临床特点分析[J]. 临床消化病杂志, 2019, 31(2): 89-92. DOI: 10.3870/lcxh.j.issn.1005-541X.2019.02.05.
    [13]
    ENOMOTO H, UENO Y, HIASA Y, et al. Transition in the etiology of liver cirrhosis in Japan: a nationwide survey[J]. J Gastroenterol, 2020, 55(3): 353-362. DOI: 10.1007/s00535-019-01645-y.
    [14]
    YOUNOSSI Z, STEPANOVA M, SANYAL AJ, et al. The conundrum of cryptogenic cirrhosis: Adverse outcomes without treatment options[J]. J Hepatol, 2018, 69(6): 1365-1370. DOI: 10.1016/j.jhep.2018.08.013.
    [15]
    ROESCH-DIETLEN F, GONZÁLEZ-SANTES M, SÁNCHEZ-MAZA YJ, et al. Influence of socioeconomic and cultural factors in the etiology of cirrhosis of the liver[J]. Rev Gastroenterol Mex (Engl Ed), 2021, 86(1): 28-35. DOI: 10.1016/j.rgmx.2020.01.002.
    [16]
    MISHRA D, DASH KR, KHATUA C, et al. A study on the temporal trends in the etiology of cirrhosis of liver in coastal eastern odisha[J]. Euroasian J Hepatogastroenterol, 2020, 10(1): 1-6. DOI: 10.5005/jp-journals-10018-1312.
    [17]
    HE H, KONG WJ, GAO F. Etiology and endoscopic manifestation of esophageal varices: An analysis of 295 patients[J]. J Prac Hepatol, 2017, 20(5): 550-553. DOI: 10.3969/j.issn.1672-5069.2017.05.011.

    贺欢, 孔文洁, 高峰. 295例食管静脉曲张病因及内镜下表现分析[J]. 实用肝脏病杂志, 2017, 20(5): 550-553. DOI: 10.3969/j.issn.1672-5069.2017.05.011.
    [18]
    KHANNA R, SARIN SK. Idiopathic portal hypertension and extrahepatic portal venous obstruction[J]. Hepatol Int, 2018, 12(Suppl 1): 148-167. DOI: 10.1007/s12072-018-9844-3.
    [19]
    GIOIA S, NARDELLI S, RIDOLA L, et al. Causes and management of non-cirrhotic portal hypertension[J]. Curr Gastroenterol Rep, 2020, 22(12): 56. DOI: 10.1007/s11894-020-00792-0.
    [20]
    de GOTTARDI A, RAUTOU PE, SCHOUTEN J, et al. Porto-sinusoidal vascular disease: proposal and description of a novel entity[J]. Lancet Gastroenterol Hepatol, 2019, 4(5): 399-411. DOI: 10.1016/S2468-1253(19)30047-0.
    [21]
    GIUDICELLI H, RAUTOU PE, PARADIS V, et al. Porto-sinusoidal vascular disease. Vascular liver diseases: position papers from the francophone network for vascular liver diseases, the french association for the study of the liver (afef), and ern-rare liver[J]. Clin Res Hepatol Gastroenterol, 2020, 44(4): 447-451. DOI: 10.1016/j.clinre.2020.03.005.
    [22]
    RAJESH S, MUKUND A, SUREKA B, et al. Non-cirrhotic portal hypertension: an imaging review[J]. Abdom Radiol (Ny), 2018, 43(8): 1991-2010. DOI: 10.1007/s00261-018-1570-8.
    [23]
    KANG JH, KIM DH, KIM SY, et al. Porto-sinusoidal vascular disease with portal hypertension versus liver cirrhosis: differences in imaging features on CT and hepatobiliary contrast-enhanced MRI[J]. Abdom Radiol (NY), 2021, 46(5): 1891-1903. DOI: 10.1007/s00261-020-02831-w.
    [24]
    CHOUGULE A, RASTOGI A, MAIWALL R, et al. Spectrum of histopathological changes in patients with non-cirrhotic portal fibrosis[J]. Hepatol Int, 2018, 12(2): 158-166. DOI: 10.1007/s12072-018-9857-y.
    [25]
    VERHEIJ J, SCHOUTEN JN, KOMUTA M, et al. Histological features in western patients with idiopathic non-cirrhotic portal hypertension[J]. Histopathology, 2013, 62(7): 1083-1091. DOI: 10.1111/his.12114.
    [26]
    KMEID M, LIU X, BALLENTINE S, et al. Idiopathic non-cirrhotic portal hypertension and porto-sinusoidal vascular disease: review of current data[J]. Gastroenterology Res, 2021, 14(2): 49-65. DOI: 10.14740/gr1376.
    [27]
    JAIN M, VENKATARAMAN J, VARGHESE J, et al. Explant liver evaluation decodes the mystery of cryptogenic cirrhosis![J]. Jgh Open, 2020, 4(1): 39-43. DOI: 10.1002/jgh3.12200.
    [28]
    NAYAK NC, VASDEV N, SAIGAL S, et al. End-stage nonalcoholic fatty liver disease: evaluation of pathomorphologic features and relationship to cryptogenic cirrhosis from study of explant livers in a living donor liver transplant program[J]. Hum Pathol, 2010, 41(3): 425-430. DOI: 10.1016/j.humpath.2009.06.021.
    [29]
    ESLAM M, SANYAL AJ, GEORGE J, et al. MAFLD: A consensus-driven proposed nomenclature for metabolic associated fatty liver disease[J]. Gastroenterology, 2020, 158(7): 1999-2014. e1. DOI: 10.1053/j.gastro.2019.11.312.
    [30]
    NOUREDDIN M, CHAN JL, BARRADAS K, et al. Attribution of nonalcoholic steatohepatitis as an etiology of cirrhosis for clinical trials eligibility: recommendations from the multi-stakeholder liver forum[J]. Gastroenterology, 2020, 159(2): 422-427. DOI: 10.1053/j.gastro.2020.04.039.
    [31]
    TINIAKOS DG, BRAIN JG, BURY YA. Role of histopathology in autoimmune hepatitis[J]. Dig Dis, 2015, 33 (Suppl 2): 53-64. DOI: 10.1159/000440747.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(1)

    Article Metrics

    Article views (1116) PDF downloads(300) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return