Proposal of a new staging and grading system of the liver for primary biliary cirrhosis.

Abstract

AIMS:

To define a new histological staging and grading system for primary biliary cirrhosis (PBC), to provide more information reflecting clinical laboratory data and the prognosis to hepatologists.

METHODS AND RESULTS:

First, 17 histological lesions of PBC were scored in 188 needle liver biopsy specimens. Factor analysis yielded three independent groups of factors: factor 1 (fibrosis, fibrous piecemeal necrosis, orcein-positive granules, bile plugs, Mallory bodies, feathery degeneration, bile duct loss and atypical ductular proliferation); factor 2 (portal inflammation, eosinophilic infiltration, lymphoid follicles, epithelioid granulomas, interface hepatitis and chronic cholangitis); and factor 3 (interface hepatitis, lobular hepatitis, acidophilic bodies and pigmented macrophages). The eight findings of factor 1, but not factors 2 and 3, were significantly correlated with clinical laboratory data and scores in the Mayo Clinic's prognostic model. Factor 1 lesions may reflect histological progression (staging), while factor 2 and 3 lesions may relate to necroinflammatory activity (grading). Then, we devised a staging and grading system using three lesions (bile duct loss, fibrosis and orcein-positive granules) from factor 1 and three from factors 2 and 3 (chronic cholangitis, interface hepatitis and lobular hepatitis).

CONCLUSION:

This new system might provide more pathological information on PBC patients for hepatologists.

• Authors: K Hiramatsu, H Aoyama, Y Zen, S Aishima, S Kitagawa, Y Nakanuma
• Journal: Histopathology (Histopathology) Vol. 49 Issue 5 Pg. 466-78 (Nov 2006) ISSN: 0309-0167 [Print] England
• PMID: 17064292 (Publication Type: Journal Article)

Topics

• Biopsy, Needle
• Disease Progression
• Humans
• Liver (pathology)
• Liver Cirrhosis, Biliary (classification, pathology, physiopathology)
• Prognosis