简化和改良组织学标准在慢性自身免疫性肝炎诊断中的比较评估
Comparative Evaluation of Simplified and Modified Histologic Criteria in the Diagnosis of Chronic Autoimmune Hepatitis.
作者信息
Sanei Mohammad H, Tamizifar Babak, Mardani Elahe, Ghaderi Amir, Tarigholeslami Elnaz, Sanei Maryam
机构信息
Department of Pathology, Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
Adv Biomed Res. 2025 Mar 28;14:21. doi: 10.4103/abr.abr_294_23. eCollection 2025.
BACKGROUND
The present study aimed at comparing simplified and modified histologic criteria alone and along with other indicators in the diagnosis of chronic autoimmune hepatitis (AIH).
MATERIALS AND METHODS
In this cross-sectional study, 48 cases were selected from slides and paraffin blocks of patients suspected of chronic AIH according to clinical and laboratory data, including serology and autoantibody findings and viral hepatitis test results. Then, scores equal to 1 (compatible hepatitis), 2 (typical hepatitis), ≤6 (probable hepatitis), and ≥7 (definite hepatitis) were calculated based on the simplified histologic criteria, modified histologic criteria, and these two criteria, along with other indicators including antinuclear antibodies (Ab), smooth muscle Ab or liver-kidney microsomal Ab or soluble liver antigen (Ag) and serum immunoglobulin G (IgG) and absence of viral hepatitis.
RESULTS
The results of this study revealed that based on the simplified histologic criteria, 43.8% and 56.3% of these cases were assigned a score of 1 and 2 points, respectively. However, calculating the total score using the simplified criteria along with other indicators showed that 60.4% and 39.6% of cases were assigned a score ≤6 and ≥7 points, respectively. Moreover, the modified histologic criteria indicated that 25% and 75% of cases were assigned a score of 1 and 2 points, respectively.
CONCLUSION
According to the findings of the present study, the modified histologic criteria compared to the simplified histologic criteria identified a higher percentage of patients assigned a score of 2 points. Moreover, modified histologic criteria, along with other indicators, were more accurate in detecting definite AIH (score ≥7 points).
背景
本研究旨在比较单独使用简化和改良组织学标准以及结合其他指标在慢性自身免疫性肝炎（AIH）诊断中的作用。
材料与方法
在这项横断面研究中，根据临床和实验室数据，从疑似慢性AIH患者的玻片和石蜡块中选取48例病例，这些数据包括血清学、自身抗体检测结果以及病毒性肝炎检测结果。然后，根据简化组织学标准、改良组织学标准以及这两种标准结合其他指标（包括抗核抗体（Ab）、平滑肌抗体或肝肾微粒体抗体或可溶性肝抗原（Ag）、血清免疫球蛋白G（IgG）以及无病毒性肝炎）计算得分，分别为1分（符合肝炎）、2分（典型肝炎）、≤6分（可能为肝炎）和≥7分（确诊肝炎）。
结果
本研究结果显示，根据简化组织学标准，这些病例中分别有43.8%和56.3%被评为1分和2分。然而，使用简化标准结合其他指标计算总分显示，分别有60.4%和39.6%的病例得分≤6分和≥7分。此外，改良组织学标准表明，分别有25%和75%的病例被评为1分和2分。
结论
根据本研究结果，与简化组织学标准相比，改良组织学标准能识别出更高比例得2分的患者。此外，改良组织学标准结合其他指标在检测确诊AIH（得分≥7分）方面更准确。
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