Proposal of a new staging and grading system of the liver for primary biliary cirrhosis

• Hiramatsu, Katsushi

• Aoyama, Hajime

• Zen, Yoh

• Aishima, Shinichi

• Nakanuma, Yasuni

抄録

金沢大学医学部附属病院病理部

Aims: To define a new histological staging and grading system for primary biliary cirrhosis (PBC), to provide more information reflecting clinical laboratory data and the prognosis to hepatologists. Methods and results: First, 17 histological lesions of PBC were scored in 188 needle liver biopsy specimens. Factor analysis yielded three independent groups of factors: factor 1 (fibrosis, fibrous piecemeal necrosis, orcein-positive granules, bile plugs, Mallory bodies, feathery degeneration, bile duct loss and atypical ductular proliferation); factor 2 (portal inflammation, eosinophilic infiltration, lymphoid follicles, epithelioid granulomas, interface hepatitis and chronic cholangitis); and factor 3 (interface hepatitis, lobular hepatitis, acidophilic bodies and pigmented macrophages). The eight findings of factor 1, but not factors 2 and 3, were significantly correlated with clinical laboratory data and scores in the Mayo Clinic's prognostic model. Factor 1 lesions may reflect histological progression (staging), while factor 2 and 3 lesions may relate to necroinflammatory activity (grading). Then, we devised a staging and grading system using three lesions (bile duct loss, fibrosis and orcein-positive granules) from factor 1 and three from factors 2 and 3 (chronic cholangitis, interface hepatitis and lobular hepatitis). Conclusion: This new system might provide more pathological information on PBC patients for hepatologists. © 2006 The Authors.

収録刊行物

• Histopathology

  Histopathology 49 (5), 466-478, 2006-11-01

  Blackwell Publishing

キーワード

• Cholangitis
• Cholestasis
• Grading
• Overlap syndrome
• Primary biliary cirrhosis
• Staging

詳細情報

• CRID: 1050001335983809664
• NII論文ID: 120000809730
• ISSN: 03090167
• Web Site: http://hdl.handle.net/2297/3029
• 本文言語コード: en
• 資料種別: journal article
• データソース種別:
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  • CiNii Articles