Histologic Staging Stage 0
Stage 1
No Fibrosis
Stage 2
Few septa
Portal Fibrosis
Stage 3
Numerous septa
Stage 4
Cirrhosis
1
ESOFAGO NORMAL
VARICES ESOFAGICA
Conversion Between FibroTest and Fibrosis Stages FibroTest Value
METAVIR Knodell Ishak Fibrosis Stage Fibrosis Stage Fibrosis Stage Estimate Estimate Estimate 0.75 – 1.00 F4 F4 F6 0.73 – 0.74
F3 – F4
F3 – F4
F5
0.59 – 0.72
F3
F3
F4
0.49 – 0.58
F2
F1 – F3
F3
0.32 – 0.48
F1 – F2
F1 – F3
F2 – F3
0.28 – 0.31
F1
F1
F2
0.22 – 0.27
F0 – F1
F0 – F1
F1
0.00 – 0.21
F0
F0
F0
Poynard T et al. Comp Hepatol. 2004;3:8-19.
Alfa fetoproteĂna + Estudio de imagen
CIRROSIS
J Clin Gastroenteroll 2006; 40.
FibroTest-Actitest® Non-invasive Tests • FibroTest®: Diagnoses hepatic fibrosis • ActiTest®: Assesses viral necro-inflammatory activity • Tests use an algorithm based on the patients’ gender, age, weight, height and specific blood biomarkers – – – – – –
Alpha-2 macroglobulin Haptoglobin Apoliproprotein A1 Total bilirubin GGT ALT Results 0.50 (F2)
Adapted from http://www.biopredictive.com. Accessed 02/18/08.
Results 0.38 (A1-A2)
FIBROMAX
FibroScanÂŽ Non-invasive Medical Diagnostic Aid
From Presentation File, May 2007, Artemis Medical and Echosens. Available at http://www.liverhealth.co.uk/. Accessed 02/18/08.
FibroScanÂŽ Non-invasive Medical Diagnostic Aid
Each measurement is made on a portion of liver representing a cylindrical specimen 1 cm in diameter and 4 cm long, From Presentation File, May 2007, Artemis Medical and Echosens. Available at http://www.liverhealth.co.uk/. Accessed 02/18/08.
Liver Stiffness Values for Each Fibrosis Stage
Elasticity (ÎşPa)
102
101
100
F01
F2
F3
F4
Fibrosis Stage Length of box represents interquartile range within which are located 50% of the values; lines through middle of box represent the median; error bars are minimum and maximum values Ziol M et al. Hepatology 2005;41:48-54.
AIXPLORER ELASTOGRAFIA
FIBROSCAN AIXPLORER. Estudios no invasivos
BIOPSIA HEPATICA
BIOPSIA HEPATICA
Circulaciรณn Hepรกtica