UCL Institute of Liver and Digestive Health, Royal Free Hospital, London, UK.
Academic department of Histopathology, UCL, London, UK.
Liver Int. 2021 Jul;41(7):1608-1613. doi: 10.1111/liv.14909. Epub 2021 May 7.
Collagen proportionate area (CPA, %) is used to quantify liver fibrosis. Here, we assessed CPA performance to sub-classify cirrhosis. CPA was measured in explanted livers from consecutively transplanted patients for hepatitis C virus-related cirrhosis. Model for end-stage liver disease (MELD), Child-Pugh score and decompensating events (ascites, variceal bleeding, non-obstructive jaundice and encephalopathy) were recorded at the time of liver transplant. Of the 154 patients, 24%, 12%, 35%, 24% and 5% had zero, one, two, three and four previous decompensating events. Patients with decompensation had significantly higher CPA than those without (25.1 ± 8.4 vs 15.8 ± 5.5, P < .001). Decompensation was independently associated with CPA, bilirubin and albumin or with CPA and MELD score. CPA did not differ between patients with one, two, three or four decompensating events (22.2 ± 6.3 vs 26.6 ± 8.9 vs 24.5 ± 7.7 vs 24.4 ± 10.9, P = .242). Overall, CPA correlates with the clinical severity of cirrhosis until the advent of decompensation but not with subsequent decompensating events.
胶原比例面积（CPA，%）用于量化肝纤维化。在这里，我们评估了 CPA 对肝硬化的亚分类表现。在连续移植的丙型肝炎病毒相关肝硬化患者的肝移植中测量了 CPA。在肝移植时记录了终末期肝病模型（MELD）、Child-Pugh 评分和失代偿事件（腹水、静脉曲张出血、非梗阻性黄疸和肝性脑病）。在 154 名患者中，24%、12%、35%、24%和 5%的患者分别有 0、1、2、3 和 4 次失代偿事件。失代偿患者的 CPA 显著高于无失代偿患者（25.1±8.4 vs 15.8±5.5，P<0.001）。失代偿与 CPA、胆红素和白蛋白独立相关，或与 CPA 和 MELD 评分相关。有 1、2、3 或 4 次失代偿事件的患者之间的 CPA 无差异（22.2±6.3 vs 26.6±8.9 vs 24.5±7.7 vs 24.4±10.9，P=0.242）。总体而言，CPA 与肝硬化的临床严重程度相关，直到失代偿发生，但与随后的失代偿事件无关。
