A histological semiquantitative scoring system for evaluation of hepatic fibrosis in needle liver biopsy specimens: Comparison with morphometric studies

Abstract

The evaluation of hepatic fibrosis on histological sections is of great interest for the staging and follow-up of chronic liver disease. Because no reliable scoring system is yet available, we have designed a semiquantitative scoring system in which the four main sites of fibrotic deposit--centrilobular vein, portal tract and perisinusoidal space, together with width and number of septa when present--are analyzed. These different items have been previously settled from comparison with morphometric measurements to evaluate surface density of total collagen performed on the same liver needle biopsy specimens stained with picro-sirius. The score has been tested on samples from 200 consecutive patients with various liver diseases and compared with the surface density of total collagen and Knodell scoring system. For observer variation study, the features by three independent pathologists were coded on 20 cases. There was a good interobserver (Kendall's tau-b = 0.75) and intraobserver (tau-B = 0.73) reproducibility. Each component of the fibrosis scoring system and total collagen surface density were significantly linearly related (one-way polynomial analysis, p < 10(-4); the correlation between semiquantitative scoring system and surface density of total collagen was 0.73 (p < 10(-5). Our semiquantitative scoring system, simple and reproducible, describes both liver architecture and fibrotic deposit. It is better related to morphometric measurement of fibrosis than each of its constituents or than the fibrosis item of the Knodell scoring system. It represents a reliable and convenient method for fibrosis evaluation, which is mandatory for clinical use.

Changes of liver fibrosis in chronic hepatitis C patients with no response to interferon-α therapy: including quantitative assessment by a morphometric method

“…8 This image analysis of liver fibrosis has been shown to correlate well with the chemical determination of liver hydroxyproline, 15 and with a histological semi-quantitative scoring system. 16 Kage et al 17 reported a significant correlation between fibrosis stage and the area of fibrosis calculated with morphometry equipment. In this study, we used a quantitative procedure to determine "improved" or "worsened" only when the fibrosis stage was the same in two specimens, and we observed regression of liver fibrosis irrespective of ALT levels after IFN therapy when fibrosis was assessed by fibrotic ratio together with staging, whereas histological evaluation of staging alone did not detect any significant difference in improvement rate between our two groups.…”

Primary Liver Injury and Delayed Resolution of Liver Stiffness after Alcohol Detoxification in Heavy Drinkers with the PNPLA3 Variant I148M

“…Histological semiquantitative scoring of macro and microvesicular steatosis, lobular inflammation, hepatocellular ballooning, Mallory-Denk bodies and apoptosis as well as fibrosis staging was performed exactly as described by Kleiner et al [36] . In addition, fibrosis was also assessed using the semiquantitative method of Chevallier et al [37] and collagen content was quantified by computerassisted image analysis of Sirius Red stained sections (morphometry). The histological diagnosis of steatohepatitis was based on the minimal criteria of steatosis (any degree), lobular inflammation and ballooning [38] .…”

Contribution of acoustic radiation force impulse (ARFI) elastography to the ultrasound diagnosis of biliary atresia

“…This score assesses the portal tract fibrosis, number and width of septa, and also the severity of central vein and perisinusoidal fibrosis with a range from 0 (normal) to 37 (most severe fibrosis) [16].…”