Centrizonal arteries and microvessels in nonalcoholic steatohepatitis.
Centrizonal arteries and microvessels in nonalcoholic steatohepatitis.
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DOI：
10.1097/pas.0b013e3182254283
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发表时间：
2011-09
期刊：
影响因子：
--
通讯作者：
Ferrell LD
中科院分区：
文献类型：
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作者：
Gill RM;Belt P;Wilson L;Bass NM;Ferrell LD
Correct classification of non-alcoholic steatohepatitis (NASH) liver biopsies is of critical importance and relies on correct orientation to microscopic liver architecture. Centrizonal arteries can cause central zones to be mistaken for portal tracts, especially in the setting of centrizonal ductular reaction, and result in either missed diagnosis or inaccurate staging of NASH. 100 randomly selected biopsies from NASH Clinical Research Network participants (2/05-8/06, fibrosis stage >1a,) were evaluated for arteries and CD34 positive microvessels in the centrizonal region. Prevalence of both centrizonal arteries and CD34 positive microvessels was graded as 0 (none in central zones), 1 (1-2 central zones with vessels), 2 (< 50% of central zones with vessels), or 3 (≥ 50% of central zones with vessels). Centrizonal arteries and CD34 positive microvessels were present in 40 and 100 cases (40% and 100%), respectively. Arteries and CD34 positive microvessels were more commonly found in central zones in biopsies with greater degrees of fibrosis; 62% with arteries in stage 3-4 vs. 21% in stage 1-2 and 70% with microvessels in stage 3-4 vs. 25% in stage 1-2, with increased prevalence of both centrizonal arteries and CD34 positive microvessels correlating directly with fibrosis stage (p<0.001). Ductular reaction was a common finding (55%) in patients with central zone arteries. The presence of an aberrant centrizonal artery must be recognized to allow for correct orientation to liver architecture in NASH and, together with the finding of increased CD34 positive microvessel formation in higher stage fibrosis, suggests a possible association between neoangiogenesis and NASH progression to cirrhosis.
