Wu Q, Zhao X, You H
Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
National Clinical Research Center for Digestive Diseases, Beijing, China.
Braz J Med Biol Res. 2017 May 18;50(6):e5234. doi: 10.1590/1414-431X20175234.
This study aimed to test the diagnostic performance of a fully quantitative fibrosis assessment tool for liver fibrosis in patients with chronic hepatitis B (CHB), primary biliary cirrhosis (PBC) and non-alcoholic steatohepatitis (NASH). A total of 117 patients with liver fibrosis were included in this study, including 50 patients with CHB, 49 patients with PBC and 18 patients with NASH. All patients underwent liver biopsy (LB). Fibrosis stages were assessed by two experienced pathologists. Histopathological images of LB slices were processed by second harmonic generation (SHG)/two-photon excited fluorescence (TPEF) microscopy without staining, a system called qFibrosis (quantitative fibrosis) system. Altogether 101 quantitative features of the SHG/TPEF images were acquired. The parameters of aggregated collagen in portal, septal and fibrillar areas increased significantly with stages of liver fibrosis in PBC and CHB (P<0.05), but the same was not found for parameters of distributed collagen (P>0.05). There was a significant correlation between parameters of aggregated collagen in portal, septal and fibrillar areas and stages of liver fibrosis from CHB and PBC (P<0.05), but no correlation was found between the distributed collagen parameters and the stages of liver fibrosis from those patients (P>0.05). There was no significant correlation between NASH parameters and stages of fibrosis (P>0.05). For CHB and PBC patients, the highest correlation was between septal parameters and fibrosis stages, the second highest was between portal parameters and fibrosis stages and the lowest correlation was between fibrillar parameters and fibrosis stages. The correlation between the septal parameters of the PBC and stages is significantly higher than the parameters of the other two areas (P<0.05). The qFibrosis candidate parameters based on CHB were also applicable for quantitative analysis of liver fibrosis in PBC patients. Different parameters should be selected for liver fibrosis assessment in different stages of PBC compared with CHB.
本研究旨在测试一种用于慢性乙型肝炎（CHB）、原发性胆汁性肝硬化（PBC）和非酒精性脂肪性肝炎（NASH）患者肝纤维化的全定量纤维化评估工具的诊断性能。本研究共纳入117例肝纤维化患者，其中CHB患者50例，PBC患者49例，NASH患者18例。所有患者均接受了肝活检（LB）。由两位经验丰富的病理学家评估纤维化分期。肝活检切片的组织病理学图像通过二次谐波产生（SHG）/双光子激发荧光（TPEF）显微镜在未染色的情况下进行处理，该系统称为qFibrosis（定量纤维化）系统。共获取了101个SHG/TPEF图像的定量特征。PBC和CHB患者门静脉、间隔和纤维区域聚集性胶原的参数随肝纤维化分期显著增加（P<0.05），但分布性胶原的参数未发现同样的情况（P>0.05）。门静脉、间隔和纤维区域聚集性胶原的参数与CHB和PBC患者的肝纤维化分期之间存在显著相关性（P<0.05），但这些患者的分布性胶原参数与肝纤维化分期之间未发现相关性（P>0.05）。NASH参数与纤维化分期之间无显著相关性（P>0.05）。对于CHB和PBC患者，最高相关性存在于间隔参数与纤维化分期之间，其次是门静脉参数与纤维化分期之间，最低相关性存在于纤维参数与纤维化分期之间。PBC的间隔参数与分期之间的相关性显著高于其他两个区域的参数（P<0.05）。基于CHB的qFibrosis候选参数也适用于PBC患者肝纤维化的定量分析。与CHB相比，PBC不同阶段的肝纤维化评估应选择不同的参数。
