Histopathological study of chronic hepatitis B and C: a comparison of two scoring systems
Histopathological study of chronic hepatitis B and C: a comparison of two scoring systems
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DOI：
10.1016/s0168-8278(02)00357-4
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发表时间：
2003-02-01
影响因子：
25.7
通讯作者：
Ramakrishna, B
中科院分区：
文献类型：
--
作者：
Rozario, R;Ramakrishna, B
背景/目的：几种组织学评分系统用于评估慢性病毒性肝炎。本研究进行，以确定Ishak系统（修改后的组织学活动指数，HAI）和METAVIR系统之间的相关性，在印度慢性病毒性hepatitis. Methods：肝活检127例慢性病毒性肝炎B或C进行了检查，并使用Ishak和METAVIR系统进行评分，并进行加权Kappa相关性分析。结果：HBV感染占64.6%，HCV感染占35.4%，91.3%的患者有轻微或轻度肝炎。Ishak和METAVIR系统的坏死性炎症评分相关性中等（加权kappa 0.627），而与纤维化相关性极佳（加权kappa 0.998）。当HBV和HCV病例分别分析时，发现了类似的一致性。HAI与血清转氨酶相关性较差（加权kappa 0.21）。结节性肝硬化，淋巴聚集，胆管损伤，胆管增生和脂肪变性显着更常见的HCV活检相比，HBV。结论：Ishak和METAVIR评分系统之间的一致性是良好的坏死性炎症变化，和优秀的纤维化变化。(C)2002年欧洲肝脏研究协会。出版社：Elsevier Science BN All rights reserved.
Background/Aims: Several histological scoring systems are used to evaluate chronic viral hepatitis. This study was undertaken to determine the correlation between the Ishak system (modified histological activity index, HAI) and the METAVIR system, in Indian patients with chronic viral hepatitis.Methods: Liver biopsies from 127 patients with chronic viral hepatitis B or C were examined, and scored using the Ishak and METAVIR systems, and weighted kappa analysis of correlation was done. Correlation of necroinflammatory activity with serum transaminase levels was analyzed, and prevalence of specific histological features compared in hepatitis B virus (HBV) and HCV biopsies.Results: HBV infection accounted for 64.6% of cases, and HCV for 35.4%; 91.3% of patients had minimal or mild hepatitis. The necroinflammatory scores of the Ishak and METAVIR systems correlated moderately well (weighted kappa 0.627), while there was excellent correlation with regard to fibrosis (weighted kappa 0.998). Similar concordance was found when HBV and HCV cases were analyzed separately. HAI showed poor correlation with serum transaminases (weighted kappa 0.21). Micronodular cirrhosis, lymphoid aggregates, bile duct damage, bile ductular proliferation and steatosis were significantly more common in HCV biopsies compared to HBV.Conclusions: Concordance between Ishak and METAVIR scoring systems is good for necroinflammatory change, and excellent for fibrotic change. (C) 2002 European Association for the Study of the Liver. Published by Elsevier Science BN. All rights reserved.