VALIDATED AND PERSPECTIVE METHODS OF NON-INVASIVE DIAGNOSTICS OF LIVER CIRRHOSIS AND ITS COMPLICATIONS
Abstract
The article provides a review of literature data on the problem of validated and promising methods of diagnostics of liver cirrhosis and its complications. A significant role in the development of diagnostic approaches in hepatology is played by the introduction of non-invasive methods. For diagnostics of liver cirrhosis (LC) liver biopsy remains the gold standard despite the risk of injuries and dependence of result accuracy on biopsy technique and qualification of the pathomorphologist. Non-invasive methods for the diagnosis of cirrhosis are currently of great importance. Methods of non-invasive diagnosis of LC are divided into instrumental and serologic. Transient elastography demonstrates high sensitivity for the diagnosis of both LC and portal hypertension (PH). The following serologic markers can be used for diagnosis of PH: osteopontin, Willebrand factor, Pro-C5 (the formation marker procollagen type V), CD163, ELF (Enhanced liver fibrosis test), ICG-r15 (indocyanine green 15 min retention test). Serologic methods are divided into commercially protected and not commercially protected methods, for example, APRI and FIB-4. In this article we also discuss the methods of non-invasive diagnosis of liver cirrhosis complications. Serum homocysteine, fecal calprotectin and nomogram can be used to diagnose spontaneous bacterial peritonitis. Serologic markers interleukin-8, NGAL, KIM-1, and L-FAB can be used for diagnosis of hepatorenal syndrome. West Haven criteria, PHES scale, Stroop and inhibitor control tests are developed for the diagnosis of hepatic encephalopathy. The problem of non-invasive diagnosis of liver cirrhosis complications needs further research. Meta-analyses are necessary to determine the diagnostic accuracy of new methods.
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