Section of Digestive Diseases, Yale University and VA-CT Healthcare System, West Haven, CT, USA.
Hepatology. 2012 Apr;55(4):1146-53. doi: 10.1002/hep.24805.
We have previously shown, in a semiquantitative analysis of liver biopsies showing cirrhosis, that thickness of fibrous septa separating cirrhotic nodules and small size of cirrhotic nodules correlated independently with portal pressure (as determined by the hepatic venous pressure gradient; HVPG) and were independent predictors of the presence of clinically significant portal hypertension (PH). This study aimed to confirm these results using quantitative analysis of these biopsies using digital image analysis. Biopsies of 42 patients with cirrhosis and HVPG measurements within 6 months of the biopsy were included in the study. The following parameters were scored quantitatively and without knowledge of HVPG results: total fibrosis area, septal thickness, nodule size, and number of nodules per millimeter of length of liver biopsy. Fibrosis area was the only parameter that independently correlated with HVPG (r = 0.606; P < 0.0001). Correlation was significant, even among patients with clinically significant PH (r = 0.636; P < 0.005). Fibrosis area and nodule size were both independently predictive of the presence of clinically significant PH (r = 0.57; P = 0.003).
On quantitative analysis, fibrosis area was the parameter that correlated best with HVPG and the presence of clinically significant PH. Beyond pathophysiological implications, this also has methodological implications that are discussed in this article.
使用数字图像分析对这些活检进行定量分析，以证实这些结果。
研究纳入了 42 例肝硬化患者的活检，这些患者在活检后 6 个月内进行了 HVPG 测量。定量评分且不了解 HVPG 结果的参数包括：总纤维化面积、间隔厚度、结节大小和每毫米肝活检长度的结节数量。纤维化面积是唯一与 HVPG 独立相关的参数(r = 0.606; P < 0.0001)。即使在临床上有显著 PH 的患者中，相关性也是显著的(r = 0.636; P < 0.005)。纤维化面积和结节大小均独立预测临床上显著 PH 的存在(r = 0.57; P = 0.003)。
在定量分析中，纤维化面积与 HVPG 和临床上显著 PH 的存在相关性最佳。除了病理生理学意义外，这也具有方法学意义，本文对此进行了讨论。
