How can I find out if I have cirrhosis in time?

First of all, it is necessary to review one's own medical condition to assess whether one is at risk of cirrhosis. Currently, it is believed that patients with the following factors are more likely to develop cirrhosis: male, over 40 years of age, Hepatitis B virus genotype C, Hepatitis B virus-positive "minor triple Yang", Hepatitis B virus DNA higher than 10,000 copies/mL, and Hepatitis B patients over 30 years of age.

This is the first time that I have seen a patient with hepatitis B.

Therefore, all hepatitis B patients with the above risk factors should be screened for cirrhosis, especially those who do not have regular checkups (i.e., checking liver function every 3-6 months), and if liver function abnormalities are found during occasional checkups, they must undergo detailed tests to rule out the possibility of cirrhosis.

To date, liver aspiration biopsy ("liver biopsy") remains a reliable means of detecting cirrhosis at an early stage, and although liver biopsy may miss a small number of cirrhotic patients, it is still the most accurate test.

Liver biopsy allows early detection of cirrhosis and severe liver fibrosis with cirrhotic tendencies. However, liver biopsy is an invasive and damaging test, and some patients are skeptical and worried and are reluctant to undergo liver biopsy. Is there any other non-invasive test for early detection of cirrhosis?

Ultrasound is a routine test in the diagnosis and treatment of liver disease, which is simple and convenient. Unfortunately, the percentage of cirrhosis detected by ultrasound is very low. One of our clinical studies showed that ultrasound can only detect about 50% of cirrhosis, and some ultrasounds are misdiagnosed, and about 50% of early cirrhosis cannot be detected by ultrasound.

However, since the ability of ultrasound to screen for early cirrhosis is still poor, and nearly half of cirrhosis will still be missed when diagnosed by a typical ultrasound manifestation of cirrhosis, are there any other non-invasive means of detecting cirrhosis at an early stage?

In recent years, Europe, Asia, another popular early detection of cirrhosis of the non-invasive examination instrument, this instrument is temporarily called "FibroScanò". In Europe, the application of this instrument began at the beginning of this century, China has introduced the application of the instrument of liver fibrosis and early cirrhosis examination, hospitals across the country will gradually promote the application of the instrument.

According to the results of a joint study by a number of hospitals in France, Hong Kong and China, if the liver elasticity value (also known as "liver hardness") of the FibroScanò examination is above 18KPa, it can basically be confirmed that there is an early stage of cirrhosis (compensatory stage), and when the liver elasticity value is below 11KPa, the probability of not having cirrhosis is as high as 99%. When the liver elasticity value is below 11KPa, the probability of not having cirrhosis is as high as 99%, while patients with liver elasticity value of 11-18KPa (about 30%) need to be further confirmed by liver puncture examination.

In actual medical practice, patients with liver disease can first be screened by FibroScanò, and if the liver elasticity value is higher than 18KPa, antiviral treatment is recommended to control the development of liver disease as soon as possible to avoid aggravation of the disease;

If the liver elasticity value is under 10KPa, the disease can be monitored regularly; and patients with liver elasticity value of 10-18KPa have a 99% probability of not having cirrhosis; while patients with liver elasticity value of 11-18KPa (about 30%) need further confirmation by liver puncture.