Development of an unbiased method for the estimation of liver steatosis
Development of an unbiased method for the estimation of liver steatosis
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DOI：
10.1111/j.1399-0012.2004.00282.x
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发表时间：
2004-12-01
影响因子：
2.1
通讯作者：
Chavin, KD
中科院分区：
文献类型：
--
作者：
Fiorini, RN;Kirtz, J;Chavin, KD
背景：脂肪变性在很大程度上有助于器官的可移植性。脂肪含量为30%的肝脏有25%的机会发展为原发性无功能(PNF)。目前对苏木精伊红(H&E)染色的供体活检进行目测评价的做法是主观的。我们假设冰冻切片的H&E染色不能准确地估计给定肝活检中存在的脂肪变性的程度。为了解决评估潜在供体器官脂肪变性的问题，我们开发了一种快速、用户友好的计算机方法，基于油红O(ORO)染色肝活检组织中颜色像素的差异量化，客观地评估脂肪含量。方法：将H&E和ORO染色的人类视觉脂肪含量估计的准确性与25例供体活检冰冻切片的计算机测量结果进行比较。结果：脂肪含量为20%的样本在人类解释和计算机分析之间存在显著差异。根据染色方法，人类对脂肪的解释也有显著差异。与H&E相比，这一差异在3%到37%之间。讨论：与H&E相比，使用ORO可以更一致地估计肝脏脂肪变性，但人类的解释无法与计算机测量相关联。脂肪含量估计的这种差异可能导致拒绝潜在的可移植器官或接受边缘器官。理想情况下，我们的方案可以迅速应用于临床实践，准确和一致地测量肝脏切片中的脂肪，最终目的是增加成功移植器官的数量。
Background: Steatosis significantly contributes to an organ's transplantability. Livers with >30% fat content have a 25% chance of developing primary non-function (PNF). The current practice of evaluating a hematoxylin and eosin (H&E) stained donor biopsy by visual interpretation is subjective. We hypothesized that H&E staining of frozen sections fails to accurately estimate the degree of steatosis present within a given liver biopsy. To address this problem of evaluating steatosis in prospective donor organs, we developed a fast, user friendly computer methodology to objectively assess fat content based on the differential quantification of color pixels in Oil Red O (ORO) stained liver biopsies.Methods: The accuracy of human visual estimation of fat content by H&E and ORO stains was compared with computer-based measurements of the same slides from 25 frozen sections of donor biopsies.Results: Samples with a fat content >20% showed marked variation between human interpretation and computer analysis. There was also a significant difference in the human interpretation of fat based on the method of staining. This difference ranged from 3 to 37% with H&E.Discussion: Use of ORO resulted in a more consistent estimation of liver steatosis compared with H&E, but human interpretations failed to correlate with computer measurements. Such differences in fat content estimations might result in the rejection of a potentially transplantable organ or the acceptance of a marginal one. Ideally, our protocol can rapidly be applied to clinical practice for accurate and consistent measurement of fat in liver sections for the ultimate purpose of increasing the number of successful transplantable organs.