Assessment of donor liver steatosis: Pathologist or automated software?
Assessment of donor liver steatosis: Pathologist or automated software?
复制标题
DOI：
10.1016/j.humpath.2003.10.029
复制
发表时间：
2004-04-01
期刊：
影响因子：
3.3
通讯作者：
Nyberg, SL
中科院分区：
文献类型：
--
作者：
Marsman, H;Matsushita, T;Nyberg, SL
供体肝活检标本中的脂肪变性与原位肝移植后移植物功能障碍有关。这个由两部分组成的研究（实验室试点，临床回顾性）比较了病理学家对脂肪变性的传统解释和由图像分析系统确定的自动测量。在我们的初步研究中，我们对Sprague-Dawley大鼠进行了前瞻性研究，给它们喂食缺乏胆碱的食物长达7天。在我们的临床组中，回顾性回顾了49例连续的尸体肝移植受者的资料。在这两项研究中，肝脏活检标本中微泡脂肪、大泡脂肪和总脂肪含量的百分比由自动图像分析软件程序和病理学家使用同一组载玻片确定。在临床研究中还检测了供肝脂肪含量与患者和移植物存活之间的关系，以及移植后天冬氨酸转氨酶、丙氨酸转氨酶、凝血酶原时间和总胆红素的水平。病理学家测定的大泡脂肪水平与使用缺乏胆碱饮食的大鼠肝脏和已故供者肝脏的自动软件之间存在直接关联。两种技术在供肝活检中观察到大泡脂肪含量与移植物存活率之间存在显著关联。我们得出结论，图像分析系统可用于自动确定肝活检标本中的脂肪含量，其发现与病理学家的视觉解释和移植物存活相关。需要进一步的研究来确定自动化技术在评估供肝移植中的作用。(C) 2004爱思唯尔公司版权所有。
Steatosis in donor liver biopsy specimens has been shown to correlate with graft dysfunction after orthotopic liver transplantation. This 2-part (laboratory pilot, clinical retrospective) study compared the traditional interpretation of steatosis by a pathologist with an automated measurement determined by an image analysis system. In our pilot study, Sprague-Dawley rats were studied prospectively by feeding them a choline-deficient diet for up to 7 days. In our clinical group, data from 49 consecutive recipients of cadaveric liver transplantation were reviewed retrospectively. In both studies, the percentages of microvesicular fat, macrovesicular fat, and total fat content within liver biopsy specimens were determined by an automated image analysis software program and a pathologist using the same set of slides. The association between fat content of the donor liver and patient survival and graft survival, along with levels of aspartate aminotransferase, alanine aminotransferase, prothrombin time, and total bilirubin after transplantation, were also examined in the clinical study. A direct correlation was observed between levels of macrovesicular fat determined by a pathologist and the automated software using livers from rats fed a choline-deficient diet and livers from deceased donors. A significant association was observed between macrovesicular fat content in the donor liver biopsy and graft survival by both techniques. We conclude that an image analysis system can be used to automate the determination of fat content in liver biopsy specimens, and that its findings correlate with both the visual interpretation by a pathologist and graft survival. Further study is needed to determine the role of an automated technique in the evaluation of donor livers for transplantation. (C) 2004 Elsevier Inc. All rights reserved.