An appraisal of the histopathological assessment of liver fibrosis

Standish, Richard

doi:10.1136/gut.2005.084475

Cited by 389 publications

(367 citation statements)

References 63 publications

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“…The upward curving slope observed in the relationship between the mean liver stiffness and fibrosis stage may be related to varying rates of fibrosis progression with advancing disease. An alternative explanation may be that the limitations of the discrete values used in the histological scoring systems, preventing a true ordinal discrimination between early and intermediate stages (5). However, these results are in agreement with observations from different research groups using ultrasound-based transient elastography (17,(39)(40)(41) and MR Elastography techniques (27-29).…”

Section: Discussionsupporting

confidence: 86%

“…The mean liver biopsy length was 2.0 ± 0.9 cm (range 0.9 -5.3 cm). The mean number of complete portal tracts available for assessment was 10 ± 4 (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Stage of fibrosis was noted as 0 to 1 (40%), 2 to 3 (20%), and 4 (40%).…”

Section: Patient and Volunteer Demographics And Diagnosesmentioning

confidence: 99%

“…Traditionally, the gold standard for detecting hepatic fibrosis is percutaneous liver biopsy. However, the widespread use of liver biopsy for defining the burden of hepatic fibrosis is not feasible based on inherent problems that include sampling error, cost, and poor acceptance of the technique by patients (5,6). Thus, the lack of alternate, accurate diagnostic methods and continued reliance on liver biopsy represents a major obstacle to understanding the natural history of hepatic fibrogenesis, as well as determining the efficacy of emerging anti-fibrotic therapies in humans (7).…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Hepatic Fibrosis With Magnetic Resonance Elastography

Yin

Talwalkar

Glaser

et al. 2007

Clinical Gastroenterology and Hepatology

855

809

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Background & Aims-Accurate detection of hepatic fibrosis is crucial for assessing prognosis and candidacy for treatment in patients with chronic liver disease. Magnetic Resonance (MR) Elastography, a technique for quantitatively assessing the mechanical properties of soft tissues, has previously been shown to have potential for non-invasively detecting liver fibrosis. The goal of this work was to obtain preliminary estimates of the sensitivity and specificity of the technique in diagnosing liver fibrosis, and to assess its potential for identifying patients who can potentially avoid biopsy.

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Section: Discussionsupporting

confidence: 86%

Section: Patient and Volunteer Demographics And Diagnosesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of Hepatic Fibrosis With Magnetic Resonance Elastography

Yin

Talwalkar

Glaser

et al. 2007

Clinical Gastroenterology and Hepatology

855

809

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“…In our study, a minimum length of at least 1.0 cm from the liver biopsy and at least six complete portal tracts were required for study inclusion [20]. But Standish et al have suggested a minimum of 11 portal tracts as a requirement to allow for reliable fibrosis estimates especially in patients with hepatitis C [30]. In our study, only 71% of the biopsy samples had a minimum of 11 portal tracts and this is a limitation of this study.…”

Section: Discussionmentioning

confidence: 77%

Non-Invasive Index for Predicting Significant Liver Fibrosis: Comparison of Diagnostic Performances in Patients with Chronic Hepatitis B and C

Cheong

Seo

et al. 2010

Dig Dis Sci

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Background/Aims The majority of non-invasive markers of liver fibrosis have been developed in patients with chronic hepatitis C. We aimed to develop a formula for predicting significant fibrosis in patients with chronic viral hepatitis and to compare the usefulness of published models derived from the data obtained from patients with chronic hepatitis C. Methods Serum markers and the METAVIR stage of fibrosis in liver biopsy specimens were compared prospectively in patients with chronic hepatitis B and C (estimation set, 367; validation set, 159). Results In the estimation set, multiple forward stepwise logistic regression analysis identified c-glutamyl transpeptidase, haptoglobin, a2-macroglobulin, matrix metalloproteinase-2, and tissue inhibitor of metalloproteinase-1 as independent predictors of significant fibrosis. A formula termed the SF index was constructed with the aforementioned five variables. The areas under the receiver operating characteristic curves of the SF index for predicting significant fibrosis were 0.828, 0.776, and 0.827 in the estimation, validation, and total sets, respectively. Using cut-off scores of 2.2 and 3.3, significant fibrosis was predicted with considerable accuracy. The diagnostic performances of the SF index and the Zeng index derived from chronic hepatitis B patients were much better than indices derived from chronic hepatitis C patients, such as the APRI, Forns index, and FIB-4. Conclusions We developed a novel formula for predicting significant fibrosis in patients with chronic viral hepatitis. Serum indices from studies in patients with chronic hepatitis C were less accurate in patients with chronic hepatitis B for predicting significant fibrosis.

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“…Computer-assisted image analysis of histochemically stained sections is a method for measuring fibrosis morphologically. It does not hinder other necessary diagnostic evaluations, and collagenous structures irrelevant to the disease process (which contribute to the variability between samples) can be excluded [56]. Considering any scoring system, the experience of the histopathologist is an important variable that must be considered and optimized [57].…”

Section: Morphological Evaluation Of Liver Fibrosis: Current Methodsmentioning

confidence: 99%