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Histological Grading and Staging of Chronic Hepatitis
Murli Krishna M.D.
First published: 01 May 2021
https://doi.org/10.1002/cld.1014
Potential conflict of interest: Nothing to report.
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Abbreviations
CAH
chronic aggressive hepatitis
CH
chronic hepatitis
CN
confluent hepatocyte necrosis
CPH
chronic persistent hepatitis
HAI
Histological Activity Index
HBV
hepatitis B virus
HCV
hepatitis C virus
IASL
International Association for the Study of the Liver
METAVIR
Meta‐analysis of Histological Data in Viral Hepatitis
PMN
piecemeal necrosis
Grading and Staging of Chronic Hepatitis
The liver biopsy is often an important part of the evaluation of a patient with abnormal liver function. It is the only procedure that provides a direct visualization of the extent of liver injury. If the etiology of dysfunction is not clear or involves multiple possible causes, the biopsy findings may guide the clinical team toward establishing a diagnosis and appropriate clinical management. In the setting of a known chronic hepatitis (CH), a biopsy provides information regarding: (1) the extent of ongoing necroinflammatory activity, which is a precursor to fibrogenesis; and (2) the extent of fibrosis. These two variables have drawn comparisons with neoplastic processes and have thus been termed “grade” and “stage,” respectively. In addition, the biopsy may reveal other concurrent processes (such as fatty liver disease and iron overload) that may influence the prognosis and management. This review is limited to grading and staging of CH, such as viral and autoimmune hepatitis, and does not include discussion of steatohepatitis. It outlines the goals and basic elements of grading and staging, a historical perspective, and the common currently used systems.1-3
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发表于 2021-5-4 18:55