CHRONIC HEPATITIS - AN UPDATE ON TERMINOLOGY AND REPORTING
CHRONIC HEPATITIS - AN UPDATE ON TERMINOLOGY AND REPORTING
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DOI：
10.1097/00000478-199512000-00007
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发表时间：
1995-12-01
影响因子：
5.6
通讯作者：
LUDWIG, J
中科院分区：
文献类型：
--
作者：
BATTS, KP;LUDWIG, J
慢性活动性肝炎（CAH）、慢性迁延性肝炎（CPH）和慢性小叶性肝炎（CLH）等术语已经过时，在没有进一步说明的情况下应停止使用。这一建议是必要的，因为这些名称已经从用于分级的描述性术语变为用于形态学诊断或疾病命名或两者兼而有之的术语，这取决于个人偏好。由于这种做法引起了严重的误解，许多作者和两个国际组织建议使用一个明确的病因学术语。对于病理学家的报告实践，我们建议病理学家通过指示病因、分级和分期来常规签署具有慢性肝炎特征的活检样本。例如自身免疫性肝炎，严重，3期。这种情况下的分期表明存在发育良好的间隔纤维化，但没有结节再生。显然，对于病因诊断，形态学表现必须结合临床和实验室资料。如果没有这些信息，应报告明确的形态学诊断。因此，而不是CPH，诊断应该是门静脉性肝炎，原因不明。这种报告实践消除了模糊的术语，并避免了可能发生的不适当治疗的风险，例如，当CAH等术语用于描述威尔逊病时，被误解为自身免疫性肝炎。在过渡期内，为了便于再学习，术语CAH、CPH和CLH可以在病因诊断后面的括号中报告。
The terms chronic active hepatitis (CAH), chronic persistent hepatitis (CPH), and chronic lobular hepatitis (CLH) have become obsolete, and their use without further specifications should be discontinued. This recommendation has become necessary because these names have changed from descriptive terms, intended for grading, to terms that are used either as morphologic diagnoses or disease designations or both, depending on individual preferences. Because this practice has caused serious misunderstandings, many authors and two international groups have recommended the use of a clear etiologic terminology. For the reporting practice of pathologists, we recommend that the pathologist routinely sign out biopsy samples with features of chronic hepatitis by indicating etiology, grade, and stage. An example would be autoimmune hepatitis, severe, stage 3. The stage in this case would indicate the presence of well-developed septal fibrosis but no nodular regeneration. Obviously, for the etiologic diagnosis, morphologic findings must be integrated with clinical and laboratory data. If this information is not available, clear morphologic diagnoses should be reported. Thus, instead of CPH, the diagnosis should be portal hepatitis, cause undetermined. This reporting practice eliminates ambiguous terminology and avoids the risk of inappropriate treatment as might occur, for example, when a term such as CAH is used to describe Wilson's disease and is misunderstood to mean autoimmune hepatitis. For-a transitional period and to facilitate relearning, the terms CAH, CPH, and CLH can be reported in parentheses behind the etiologic diagnosis.