Non-invasive Assessment of Liver Fibrosis Using Serum Markers

Fibrosis is an intrinsic response to chronic injury, that elicits excess deposition of matrix compounds and scarring, which ultimately alters liver structure and function. Liver biopsy has long been the gold standard for assessing the degree of liver fibrosis. Due to liver biopsy invasiveness, specialists and patients favor alternative non-invasive tests for fibrosis staging. In recent years, many non-invasive tests based on measurement of direct or indirect serum markers have been developed. Direct and indirect markers may be used alone or, more commonly, in combination with each other, to produce composite liver fibrosis scores/panels. Almost all of them have the ability to identify significant fibrosis and cirrhosis in particular. However, only those tests with the highest diagnostic accuracy and availability should be introduced. Apart from their diagnostic accuracy, the potential ability of these tests to predict disease outcomes should be compared with that of liver biopsy. Continued research in this area will give the opportunity to offer patients with liver diseases more precise and non-invasive diagnostic tools. Until now liver biopsy still a part of clinical practice but we hope progress in biomedicine can change the current situation in the next few decades. Consequently, liver biopsy will be a history.