O'Brien M J, Keating N M, Elderiny S, Cerda S, Keaveny A P, Afdhal N H, Nunes D P
Department of Pathology, Boston University School of Medicine, MA, USA.
Am J Clin Pathol. 2000 Nov;114(5):712-8. doi: 10.1309/D7AU-EYW7-4B6C-K08Y.
The aim was to assess the validity of a digitally computed fibrosis ratio as a measure of fibrosis stage in liver biopsy specimens. We scored 230 liver biopsy specimens from patients with chronic hepatitis C for fibrosis using modified Knodell criteria; fibrosis ratios were computed from digital images that encompassed the complete trichrome-stained section of each case. Although an overall correlation between fibrosis ratio and ordinal score was present, subset analysis showed that this correlation existed only among biopsy specimens with high scores (3-6, early bridging fibrosis to established cirrhosis). There was no correlation or difference between category means found among biopsy specimens with low scores (0-3, normal to early bridging fibrosis). Furthermore, concordance by both estimates in direction of fibrosis change among serial liver biopsy specimens was found in only 11 (30%) of 37 pairs compared. The findings suggest that a qualitative assessment of the computerized fibrosis pattern is necessary for the interpretation of computerized fibrosis ratio measurements, particularly in patients with early stage fibrosis.
目的是评估数字计算的纤维化比率作为肝活检标本中纤维化阶段衡量指标的有效性。我们使用改良的Knodell标准对230例慢性丙型肝炎患者的肝活检标本进行纤维化评分；纤维化比率由包含每个病例完整三色染色切片的数字图像计算得出。虽然纤维化比率与序数评分之间存在总体相关性，但亚组分析表明这种相关性仅存在于高分（3 - 6分，早期桥接纤维化至已确立的肝硬化）的活检标本中。低分（0 - 3分，正常至早期桥接纤维化）的活检标本类别均值之间没有相关性或差异。此外，在比较的37对连续肝活检标本中，仅11对（30%）在纤维化变化方向上两种评估方法达成一致。研究结果表明，对于计算机化纤维化比率测量结果的解读，特别是在早期纤维化患者中，对计算机化纤维化模式进行定性评估是必要的。
