Application and validation of a new histologic staging and grading system for primary biliary cirrhosis
| Autor: | Mikio Zeniya, Yasuni Nakanuma, Maylee Hsu, Hiroko Ikeda, Kenichi Harada |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Cholangitis Biopsy Biliary cirrhosis Kaplan-Meier Estimate Severity of Illness Index Gastroenterology Primary biliary cirrhosis Predictive Value of Tests Internal medicine medicine Humans Chronic Cholangitis Stage (cooking) Hepatitis medicine.diagnostic_test Liver Cirrhosis Biliary business.industry Reproducibility of Results grading staging Middle Aged Prognosis medicine.disease primary biliary cirrhosis Liver Liver biopsy Predictive value of tests Disease Progression Female Bile Ducts business |
| Zdroj: | Journal of Clinical Gastroenterology. 47(2):174-181 |
| ISSN: | 0192-0790 |
| Popis: | BACKGROUND: We proposed a new grading and staging system for primary biliary cirrhosis (PBC), which takes into account the degree of both chronic cholangitis activity (CA) and hepatitic activity (HA) for grading disease activity and that of fibrosis, bile duct loss, and chronic cholestasis for staging. In this study, we validated our new system. METHODS: Using liver biopsy specimens from 166 cases of PBC, chronic cholangitis with mild periductal lymphoplasmacytic infiltration, including chronic nonsuppurative destructive cholangitis, and the combined activity of interface hepatitis and lobular hepatitis were categorized into 4 grades on the basis of their degree and distribution (CA0-3 and HA0-3, respectively). For staging, because orcein staining was not available in this study, 2 criteria (fibrosis and bile duct loss) were independently scored from 0 to 3 on the basis of their degrees, and a final stage score was created from the sum. RESULTS: Although there was a relatively uniform distribution of CA0/1/2/3 cases, the cases of HA0/1/2/3 were distributed as 21%, 64%, 13%, and 3%, respectively, with a prominent number of cases categorized as having none or mild HA. The distribution of stages 1 to 4 using our system was considerably different from that using the classic system and, importantly, showed a correlation with patient outcome. CONCLUSIONS: Our system revealed that the activities of chronic cholangitis and hepatitis did not correlate with each other in terms of degree and that our staging system properly reflected the outcome of PBC patients. The present study could validate the effectiveness of this new system for characterizing the pathologic condition of PBC. Copyright © 2013 by Lippincott Williams &Wilkins. |
| Databáze: | OpenAIRE |
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