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摘要：
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摘要：非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）已成为全球
最流行的慢性肝脏疾病。肝组织活检仍是评估NAFLD疾病严重程度的金标准，但由
于其存在有创性、潜在并发症、取样误差等局限，不适用于常规监测疾病进展与治疗
预后。肝细胞凋亡可反映NAFLD疾病进展，其中角蛋白18（cytokeratin 18，CK-18）
与肝细胞凋亡密切相关，被认为是NAFLD预测与诊断最有潜力的无创生物标志物之
一。本文主要对CK-18及其相关无创预测模型在NAFLD、非酒精性脂肪性肝炎（nonalcoholic steatohepatitis，NASH）及肝纤维化等不同疾病特征中的表现进行综述，评估
其对NAFLD风险预测和疾病进展评估中的价值，并讨论CK-18未来作为临床广泛使用
的NAFLD无创诊断工具的的可能性。
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Abstract: Non-alcoholic fatty liver disease (NAFLD) has become the most prevalent chronic
liver disease in the world. At present, liver biopsy is still the gold standard for the assessment
of NAFLD, but the clinical application of liver biopsy is limited due to some deficiencies such
as invasiveness, potential complications, and sampling errors and so on. Hepatocyte apoptosis
is a typical manifestation of the progression of NAFLD. Cytokeratin 18 (CK-18) is closely
related to hepatocyte apoptosis and is regarded as one of the most potential non-invasive
biomarkers for the risk prediction of NAFLD. This review summarized the main performances
of CK-18 and its related non-invasive prediction models in different disease grades such as
NAFLD, non-alcoholic steatohepatitis (NASH) and liver fibrosis, and assessed its value on
the prediction and diagnosis of NAFLD, and discussed the possibility of CK-18 as a clinically
widely used non-invasive diagnostic tool for NAFLD.
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