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World J Gastroenterol. Jan 14, 2014; 20(2): 475-485
Published online Jan 14, 2014. doi: 10.3748/wjg.v20.i2.475
Published online Jan 14, 2014. doi: 10.3748/wjg.v20.i2.475
Limitations of liver biopsy and non-invasive diagnostic tests for the diagnosis of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis
Yoshio Sumida, Yoshito Itoh, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
Atsushi Nakajima, Division of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
Author contributions: Nakajima A and Ioh Y equally contributed to this work; Sumida Y wrote the manuscript.
Supported by Scholarship Funds from MSD Co., Ltd. (to Sumida Y); Scholarship Funds from MSD Co., Ltd., and Dainippon Sumitomo Pharma Co., Ltd. (to Ioh Y)
Correspondence to: Yoshio Sumida, MD, PhD, Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan. sumida@koto.kpu-m.ac.jp
Telephone: +81-75-2515519 Fax: +81-75-2510710
Received: July 31, 2013
Revised: September 29, 2013
Accepted: November 3, 2013
Published online: January 14, 2014
Processing time: 171 Days and 23.2 Hours
Revised: September 29, 2013
Accepted: November 3, 2013
Published online: January 14, 2014
Processing time: 171 Days and 23.2 Hours
Core Tip
Core tip: Liver biopsies remain a gold standard, although the procedure has several limitations for the diagnosis of nonalcoholic steatohepatitis (NASH). The NAFIC score, calculated from the levels of ferritin, fasting insulin and type IV collagen 7S, is useful for diagnosing NASH, while the nonalcoholic fatty liver disease fibrosis score and the FIB-4 index are useful for excluding NASH in cases of advanced fibrosis.