Editorial
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2017; 23(2): 191-196
Published online Jan 14, 2017. doi: 10.3748/wjg.v23.i2.191
Evolving strategies for liver fibrosis staging: Non-invasive assessment
Cristina Stasi, Stefano Milani
Cristina Stasi, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
Stefano Milani, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, 50134 Florence, Italy
Author contributions: Stasi C and Milani S designed the editorial; Stasi C wrote and revised the manuscript; Milani S critically revised the manuscript for important intellectual content and has given final approval of the version to be published.
Conflict-of-interest statement: The authors declare no financial conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Cristina Stasi, MD, PhD, Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50141 Firenze, Italy. cristina.stasi@gmail.com
Telephone: +39-55-7947922 Fax: +39-55-7947922
Received: August 25, 2016
Peer-review started: August 27, 2016
First decision: October 10, 2016
Revised: October 22, 2016
Accepted: December 8, 2016
Article in press: December 8, 2016
Published online: January 14, 2017
Abstract

Transient elastography and the acoustic radiation force impulse techniques may play a pivotal role in the study of liver fibrosis. Some studies have shown that elastography can detect both the progression and regression of fibrosis. Similarly, research results have been analysed and direct and indirect serum markers of hepatic fibrosis have shown high diagnostic accuracy for advanced fibrosis/cirrhosis. The prognosis of different stages of cirrhosis is well established and various staging systems have been proposed, largely based on clinical data. However, it is still unknown if either non-invasive markers of liver fibrosis or elastography may contribute to a more accurate staging of liver cirrhosis, in terms of prognosis and fibrosis regression after effective therapy. In fact, not enough studies have shown both the fibrosis regression in different cirrhosis stages and the point beyond which the prognosis does not change - even in the event of fibrosis regression. Therefore, future studies are needed to validate non-invasive methods in predicting the different phases of liver cirrhosis.

Keywords: Elastography, Non-invasive methods, Chronic liver diseases, Stiffness, Non-invasive serum markers

Core tip: Several studies have demonstrated the accuracy of non-invasive methods to predict significant/advanced fibrosis and cirrhosis and to identify the presence/absence of fibrosis. However, it is still unknown if either non-invasive markers of liver fibrosis or elastography may contribute to a more accurate staging of liver cirrhosis, in terms of prognosis and fibrosis regression after effective therapy. Therefore, future studies are needed to validate non-invasive methods in predicting the different phases of liver cirrhosis.