Quantitative assessment of fibrosis in liver biopsies from patients with chronic hepatitis B

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Liver International

(formerly Liver)

The Official Journal of the International Association for the Study of the

Liver

Edited by:

Mei-Hwei Chang, Taiwan

L.M. Jansen, The Netherlands

Kew, South Africa

Edna Strauss, Brazil

S. Tavill, USA

Print ISSN: 1478-3223

Online ISSN: 1478-3231

Frequency: Bi-monthly

Current Volume: 24

ISI Journal Citation Reports® Ranking: 2003: 19/47 (Gastroenterology &

Hepatology)

Impact Factor: 2.076

Volume 24: Issue 6

Quantitative assessment of fibrosis in liver biopsies from patients with

chronic hepatitis B

Yui Hui

Choong-Tsek Liew

Minnie Yin-Yin Go

Angel Mei-Ling Chim

Henry Lik-Yuen Chan

Wai-Yee Leung

ph Jao-Yiu Sung

Abstract

Background/aim:

Accurate histological assessment of liver fibrosis is essential in the

management of chronic hepatitis B (CHB). Although semi-quantitative scoring

systems describe well the pathological patterns of hepatic structure, they

produce fibrosis evaluation that is not very precise. Image analysis or

morphometry has the theoretical advantage of providing truly quantitative

data.

Patients and methods:

The present study aimed at validating a new image analysis system, Bioquant

Nova Prime, in estimating collagen content in liver biopsy samples from

patients with CHB. The biopsies were stained with picrosirius red and the

areas of collagen were measured. The results were correlated with laboratory

parameters and Ishak modified histological scores. Discriminative

reliability of morphometry was determined using receiver operating

characteristics (ROC) analysis.

Results:

There was excellent interobserver agreement (r=0.84-0.94, P<0.01) in the

morphometric analysis. Significant correlations between the quantitative

morphometric data and the semi-quantitative score (Spearman's r=0.68-0.78,

P<0.001) were also demonstrated. Excellent discriminative power of

morphometry in differentiating mild from advanced fibrosis and cirrhosis

from absence of cirrhosis was shown by the ROC analysis.

Conclusions:

Our results validated the use of Bioquant Nova Prime in estimating collagen

content in liver biopsies. We showed that morphometry is a sensitive method

of liver fibrosis quantification in CHB and complements semi-quantitative

histological scoring system. This tool, with its reliable intraassay

variability, could be of special value in assessing histological response to

treatment after anti-viral or anti-fibrotic therapy.