Direct and indirect evidence for the reversibility of cirrhosis

被引:73
作者
Serpaggi, Jeanne
Carnot, Francoise
Nalpas, Bertrand
Canioni, Daniele
Guechot, Jerome
Lebray, Pascal
Vallet-Pichard, Anais
Fontaine, Helene
Bedossa, Pierre
Pot, Stanislas
机构
[1] Hop Necker Enfants Malad, Serv Hepatol, F-75014 Paris, France
[2] Hop Necker Enfants Malad, INSERM, U567, F-75014 Paris, France
[3] Hop Georges Pompidou, Serv Anat Pathol, F-75015 Paris, France
[4] Hop Necker Enfants Malad, Serv Anat Pathol, F-75015 Paris, France
[5] Hop St Antoine, Biochim Lab, F-75011 Paris, France
[6] Hop Kremlin Bicetre, Serv Anat Pathol, F-92110 Clichy, France
关键词
histopathologic improvement; specific treatment; cirrhosis; reversibility of cirrhosis;
D O I
10.1016/j.humpath.2006.07.007
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
The aim of this study was to assess the reversibility of cirrhosis after therapy in a large series of patients with cirrhosis from various etiologies. We performed a retrospective study of 113 patients with biopsy-proven cirrhosis who underwent specific therapy and follow-up biopsies. Two pathologists performed blinded analyses of indirect biochemical and morphological signs of cirrhosis. Fourteen (12.4%) of the 113 cirrhotic patients had biopsy-proven disappearance of cirrhosis, defined as a decrease of 2 or greater in their METAVIR fibrosis score: 8 were related to hepatitis C virus, 3 to hepatitis B virus, and 3 to autoimmune cirrhosis. Necro-inflammatory activity decreased from 2.4 +/- 0.65 to 0.85 +/- 0.9 (P = .004), and fibrosis from 4 to 1.7 +/- 0.61 (P = .001). Prothrombin time (n = 1), platelet count (n = 2), serum albumin level (n = 2), and ultrasound abnormalities (n = 6) normalized in patients who had initial abnormalities. Hyaluronic acid and procollagen type III serum level decreased in all. In the 11 patients with regression of viral cirrhosis, 2 were nonresponders and 9 were responders, including 2 relapsers. The 3 patients with regressive autoimmune cirrhosis were complete responders to immunosupressive therapy. Using repeated liver biopsies, clinicobiochemical, radiologic, and endoscopic tests, we provide evidence for potential reversibility of cirrhosis after long-lasting suppression of the necro-inflammatory activity of liver disease. (c) 2006 Published by Elsevier Inc.
引用
收藏
页码:1519 / 1526
页数:8
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