Stage and natural history of cirrhosis

Abstract

Cirrhosisis the final pathway of any chronic liver disease and can lead to a number of complications,including hepatocellular carcinoma. Liver fibrosis is the key role of disease progression in cirrhosis. Advanced liver fibrosis and early stage of cirrhosis are not usually clinically detectable or symptomatic.As patients develop more extensive hepatic fibrosis potentially resulting in development of cirrhoticcomplications such as variceal hemorrhage. Prognosis and survival is markedly better in patients with early stage of cirrhosis. Now there are many stages classification of cirrhosis defined by liverhistology, hepatic venous pressure gradient and clinical staging selected by complications. The knowledgeand understanding of the natural history of liver fibrosis can help for staging and early detection ofthe cirrhosis. Remove noxious stimuli, hepato-protectants and decrease hepatic inflammationand cell death are the main treatment modalities for hepatic fibrosis.
 
 Figure 1 ระยะโรคตับแข็งแบ่งตามลักษณะการดำเนินโรค (modified from Arvaniti V’s work) (12)*decompensated events เช่น ท้องมาน spontaneous bacterial peritonitisvariceal bleeding หรือโรคสมองเหตุจากโรคตับ; LT, liver transplantation
 
 
 Keywords: cirrhosis, liver fibrosis, liver histology, hepatic venous pressure gradient