Sci Rep. 2018 Feb 14;8(1):2989. doi: 10.1038/s41598-018-21179-2.
Quantitative assessment of liver fibrosis (qFibrosis) reveals precise outcomes in Ishak "stable" patients on anti-HBV therapy.Sun Y1, Zhou J1, Wu X1, Chen Y2, Piao H3, Lu L4, Ding H5, Nan Y6, Jiang W7, Wang T8, Liu H9, Ou X1, Wee A10, Theise ND11, Jia J12, You H13. Author information 1Liver Research Center, Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.2Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.3Infectious Disease Department, Affiliated Hospital of Yanbian University, Yanji, 133000, China.4Department of Gastroenterology and Hepatology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200080, China.5Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.6Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.7Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.8Pathology Department, China-Japan Friendship Hospital, Beijing, 100029, China.9Pathology Department, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.10Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, National University Hospital, Singapore, 119074, Singapore.11Department of Pathology, New York University School of Medicine, New York, NY, 10016, USA.12Liver Research Center, Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China. [email protected].13Liver Research Center, Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China. [email protected].
AbstractCurrent widely used semiquantitative histological assessment methods are insensitive to identify subtle changes of liver fibrosis. Therefore, to precisely assess therapeutic efficacy on chronic hepatitis B (CHB), we explored the utility of qFibrosis (a fully-quantitative morphometric method employing second harmonic generation/two photon excitation fluorescence) in liver fibrosis evaluation. Fibrosis changes were evaluated by Ishak fibrosis scoring and qFibrosis in CHB patients with paired liver biopsies before and after 78 weeks' antiviral therapy. A total of 162 patients with qualified paired biopsies were enrolled. Ishak fibrosis scoring revealed that 42.6% (69/162) of the patients achieved fibrosis regression (≥1-point decrease), 51.9% (84/162) remained stable, and 5.5% (9/162) showed progression (≥1-point increase). qFibrosis showed similar trends in the groups of regression and progression patients as evaluated by Ishak. However, in Ishak stable patients, qFibrosis revealed hitherto undetected changes, allowing for further subcategorization into regression ("Regression by qFibrosis"; 40/84, 47.6%), stable (29/84, 34.5%), and progression ("Progression by qFibrosis"; 15/84, 17.9%) groups. These newly fine-tuned categories were supported by changes of morphological parameters of fibrosis, collagen percentage area, and liver stiffness measurements. In conclusion, qFibrosis can be used to quantitatively identify subtle changes of liver fibrosis in CHB patients after antiviral therapy.