Foschini M P, Dal Monte R
Sezione di Anatomia, Università di Bologna.
Pathologica. 1996 Aug;88(4):263-9.
In the recent literature it has been emerged the importance of grading and staging of chronic viral hepatitis. Numerous different methods of grading and staging have been proposed. Purpose of the present paper was to compare the methods proposed by Knodell et al., Scheuer, and Ishak et al.
Forty consecutive cases of chronic viral hepatitis constituted the basis of the study. Each case was graded as mild, moderate and severe activity and staged according to the criteria described in the three methods. In particular portal-periportal activity, lobular activity and fibrosis were evaluated. The final evaluation of the liver biopsy, together with the result of each single feature, were then compared.
The three different methods gave grossly similar results in the overall grading of the cases. Analyzing the single features, differences were noted in the evaluation of the lobular activity. This is probably the consequence of the different qualitative and quantitative criteria applied. Comparison of the data obtained by evaluating the extension of fibrosis was quite difficult, owing to the extremely different scales of grading used in each single method.
In this study three different methods of grading and staging of chronic viral hepatitis were compared. The final evaluations of the cases obtained with the different methods were almost superimposable. Comparing the data obtained with long term follow-up of the patients may better clarify which of the different methods can have a prognostic value.
在最近的文献中，已凸显出慢性病毒性肝炎分级和分期的重要性。已提出了许多不同的分级和分期方法。本文的目的是比较由诺德尔等人、舍尔和伊沙克等人提出的方法。
连续40例慢性病毒性肝炎病例构成了本研究的基础。每个病例根据三种方法中描述的标准分为轻度、中度和重度活动，并进行分期。特别对汇管区-汇管周围活动、小叶活动和纤维化进行了评估。然后将肝活检的最终评估结果与每个单一特征的结果进行比较。
这三种不同的方法在病例的总体分级上给出了大致相似的结果。在分析单一特征时，发现小叶活动的评估存在差异。这可能是由于应用了不同的定性和定量标准。由于每种单一方法中使用的分级尺度差异极大，因此比较通过评估纤维化范围获得的数据相当困难。
在本研究中，比较了三种不同的慢性病毒性肝炎分级和分期方法。用不同方法获得的病例最终评估结果几乎是重叠的。比较通过对患者进行长期随访获得的数据可能会更好地阐明哪种不同方法具有预后价值。
