Histopathologischer Degenerations-Score des Faserknorpels

Abstract

Although histopathology of meniscal degeneration plays an important role, no criteria to assess severity of the degeneration are available to date. Our aim was to create a histopathological scoring system for meniscal degeneration with good interobserver variability, taking matrix degradation and cellularity in meniscal tissue into consideration. Degeneration is classified as follows: grade 1 (low), grade 2 (intermediate), grade 3 (high). The pattern of NITEGE deposits (G1 fragment of aggrecan) was assessed immunohistochemically (n=38) and compared with the grades of degeneration. In 48% of the patients with grade 2 or 3 degeneration extracellular NITEGE deposits (specificity 100%) were found, whereas grade 1 patients showed no deposits. Extracellular NITEGE deposits correlated positively with the grade of degeneration. In all, 30 cases (10 per grade) were assessed by three pathologists (A, B, C). Grading conformity was 70% for grade 1, 66% for grade 2 and 100% for grade 3. Cohen's Kappa coefficient was 0.6--0.7 between pairs of observers. Combining grade 1 and 2 to low-grade degeneration, compared to a grade-3 high-grade degeneration achieved Kappa coefficients of between 0.93 and 1.0. This reproducible degeneration score for fibrous cartilage could form the basis for the standardized assessment of meniscal degeneration.

A Porcine Animal Model for Early Meniscal Degeneration – Analysis of Histology, Gene Expression and Magnetic Resonance Imaging Six Months after Resection of the Anterior Cruciate Ligament

“…In some slides of meniscal tissue after ACLR additional pronounced mucoid changes which are characterized by less stained and overstained areas (circle in Fig 2D ) in accordance with separation and the formation of tears and multiple obvious matrix clefts have been seen mainly in the PI ( Fig 2D ) but also in the AH (Grade 3). Other criteria for high-grade degeneration that have been described previously [ 38 , 39 ] such as polymorphism of chondrocytes and fat accumulations were rare in the menisci of the current study. The lateral meniscus after ACLR showed none of the degenerative changes of this type.…”

“…For histological evaluation a published score for human meniscal tissue degeneration [ 30 , 39 ] had to be adapted as described before [ 32 ] since there is, to our knowledge, no other published scoring system for meniscal degeneration of porcine tissue. The lateral menisci from both knee joints and the medial meniscus from the right knee joint (control) showed mainly normal meniscal tissue that is homogenous matrix staining and high cellularity with uniform morphology of the chondrocytes.…”

Macroscopic and histopathologic analysis of human knee menisci in aging and osteoarthritis

“…Human meniscal degeneration has also been described by several authors [18, 20, 21, 24, 25, 31, 32, 35–37, 39, 44–49]. However, most of the grading systems for meniscus pathology are MRI-based, and describe tears and grades of mucoid degeneration [19, 50–53].…”

“…In addition, little is known of meniscus aging, at macroscopic and histopathologic levels. Most studies of animal and human tissue developed specialized evaluation systems to capture specific features of interest such as cellularity and matrix organization [11, 18, 20, 24, 25]. …”

Identification of Three Rheumatoid Arthritis Disease Subtypes by Machine Learning Integration of Synovial Histologic Features and RNA Sequencing Data

“…A hematoxylin and eosin (H&E) stain-based assessment of RA synovium is feasible for large numbers of patients undergoing interventional procedures, since it is a routine offering by clinical pathology laboratories. The Krenn scoring system of H&E-stained synovial tissue involves assessment of 3 histologic features: synovial lining hyperplasia, synoviocyte stromal density, and leukocyte infiltration (7–10). Although the presence of high-grade synovitis has a sensitivity of 62% and specificity of 96% for the diagnosis of rheumatic diseases, it does not discriminate between subtypes of rheumatic diseases, such as RA versus psoriatic arthritis.…”