The Laennec staging system for histological sub-classification of cirrhosis is useful for stratification of prognosis in patients with liver cirrhosis
The Laennec staging system for histological sub-classification of cirrhosis is useful for stratification of prognosis in patients with liver cirrhosis
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DOI：
10.1016/j.jhep.2012.04.029
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发表时间：
2012-09-01
影响因子：
25.7
通讯作者：
Park, Young Nyun
中科院分区：
文献类型：
--
作者：
Kim, Seung Up;Oh, Hyun Jung;Park, Young Nyun
背景与目的：肝硬化的临床严重程度差异很大。我们调查了是否肝硬化的组织学亚分类使用Laennec系统可以区分不同的结果之间的患者historics.Methods：175例慢性肝病谁接受肝活检，并显示阶段3或4纤维化之间2001年1月至2008年12月前瞻性入组。根据Laennec系统，肝硬化被细分为三组（4A、4B和4C）。终点是肝脏相关事件（LRE）的发生，包括失代偿、肝细胞癌和肝脏相关死亡。结果：患者（110名男性，65名女性）的中位年龄为55岁。分别在46例（26.3%）、16例（9.1%）、82例（46.9%）和31例（17.7%）患者中确定了3期、4A期、4B期和4C期。随访期间，32例（18.3%）患者发生LRE：3期4例（8.7%），4A期2例（12.5%），4B期17例（20.7%），4C期9例（29.0%）。在多变量分析中，肝硬化的组织学亚分类独立预测LRE的发生。虽然4A期患者发生LRE的风险往往高于3期患者，但4B和4C期患者发生LRE的风险显著更高，风险比为6.158（p = 0.016）和8.945（p = 0.004）。使用Laennec系统的肝硬化组织学亚分类可用于评估肝硬化患者发生LRE的风险。我们的研究为进一步研究非侵入性方法监测LRE发生的风险提供了坚实的基础，并将帮助医生建立最佳的治疗策略。(C)2012年欧洲肝脏研究协会。由Elsevier B出版。版权所有© 2016
Backgrounds & Aims: The clinical severity of cirrhosis varies widely. We investigated whether histological sub-classification of cirrhosis using the Laennec system can discriminate different outcomes among patients with cirrhosis.Methods: One hundred and seventy-five patients with chronic liver disease who underwent liver biopsy and showed stage 3 or 4 fibrosis between January 2001 and December 2008 were prospectively enrolled. Cirrhosis was sub-classified into three groups (4A, 4B, and 4C) according to the Laennec system. The end point was liver-related event (LRE) occurrence, including decompensation, hepatocellular carcinoma, and liver-related death.Results: The median age of the patients (110 men, 65 women) was 55 years. Stages 3, 4A, 4B, and 4C were identified in 46 (26.3%), 16 (9.1%), 82 (46.9%), and 31 (17.7%) patients, respectively. During the follow-up period, LREs occurred in 32 (18.3%) patients: 4 (8.7%) with stage 3, 2 (12.5%) with stage 4A, 17 (20.7%) with stage 4B, and 9 (29.0%) with stage 4C. In a multi-variate analysis, histological sub-classification of cirrhosis independently predicted LRE occurrence. While patients with stage 4A tended to be at higher risk of LRE occurrence than those with stage 3, patients with stages 4B and 4C had significantly higher risks of LRE occurrence, with hazard ratios of 6.158 (p = 0.016) and 8.945 (p = 0.004), respectively.Conclusions: Histological sub-classification of cirrhosis using the Laennec system can be used to assess the risk of LRE occurrence among patients with cirrhosis. Our study provides a solid basis for further studies of non-invasive methods for monitoring the risk of LRE occurrence and will help physicians to establish optimum treatment strategies. (C) 2012 European Association for the Study of the Liver. Published by Elsevier B. V. All rights reserved.