Document Detail

Histological subclassification of cirrhosis using the Laennec fibrosis scoring system correlates with clinical stage and grade of portal hypertension.
MedLine Citation:
PMID:  21354227     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: Further histological subclassification of cirrhosis may be useful because of heterogeneity of severity within cirrhosis. We aimed to determine the relationship between histological subclassification and clinical stage of cirrhosis as well as grade of portal hypertension.
METHODS: One hundred-twenty-three biopsy-proven cirrhosis patients, whose clinical stage of cirrhosis and hepatic venous pressure gradient (HVPG) could be estimated, were included in this prospective study. Histology of cirrhosis was blindly subclassified using the Laennec fibrosis scoring system semi-quantitatively without knowledge of the clinical stage or the HVPG results. The Laennec system subclassifies cirrhosis as mild - thin septa, moderate - at least two broad septa, and severe - at least one very broad septum or many minute nodules. Clinical stages were determined by the presence or absence of varices, ascites, and variceal hemorrhage. Biological and laboratory data were also collected.
RESULTS: Alcohol intake was the most common cause of cirrhosis in this cohort (87, 70.7%). Histology of cirrhosis subclassified using the Laennec scoring system significantly correlated with both the clinical stage of cirrhosis (p < 0.001) and HVPG (mild: 8.1 ± 2.6 mm Hg, moderate: 12.4 ± 3.3mm Hg, severe: 16.3 ± 4.0 mm Hg, p < 0.001). With higher grades of histological subclassification of cirrhosis, increased frequency in both severe portal hypertension (HVPG ≥ 12 mm Hg) and episodes of variceal hemorrhage were observed (p < 0.001).
CONCLUSIONS: Histological subclassification of cirrhosis by the Laennec fibrosis scoring system is tightly correlated with both the clinical stage of cirrhosis and grade of portal hypertension. This suggests that cirrhosis should be subclassified into different stages according to its histological severity.
Moon Young Kim; Mee Yon Cho; Soon Koo Baik; Hong Jun Park; Hyo Keun Jeon; Chong Kun Im; Chan Sik Won; Jae Woo Kim; Hyun Soo Kim; Sang Ok Kwon; Min Seob Eom; Seung Hwan Cha; Young Ju Kim; Sei Jin Chang; Samuel S Lee
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-02-24
Journal Detail:
Title:  Journal of hepatology     Volume:  55     ISSN:  1600-0641     ISO Abbreviation:  J. Hepatol.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-19     Completed Date:  2012-03-06     Revised Date:  2012-08-24    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1004-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Department of Internal Medicine, Yonsei University, Wonju College of Medicine, South Korea.
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MeSH Terms
Aged, 80 and over
End Stage Liver Disease / pathology
Esophageal and Gastric Varices / complications*,  etiology
Gastrointestinal Hemorrhage / etiology*
Hypertension, Portal / complications,  physiopathology*
Liver Cirrhosis / classification*,  complications,  pathology*
Middle Aged
Portal Pressure*
Prospective Studies
Severity of Illness Index
Statistics, Nonparametric

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