Histopathological algorithm and scoring system for evaluation of liver lesions in morbidly obese patients.
Summary of "Histopathological algorithm and scoring system for evaluation of liver lesions in morbidly obese patients."
NAFLD is highly prevalent and overweight is a significant risk factor. The aim was to build an algorithm along with a scoring system for histopathologic classification of liver lesions that covers the entire spectrum of lesions in morbidly obese patients. A cohort of 679 obese patients undergoing liver biopsy at the time of bariatric surgery was studied. An algorithm for segregating lesions into normal liver, NAFLD or NASH was built based on semi-quantitative evaluation of steatosis, hepatocellular ballooning and lobular inflammation. For each case, the SAF score was created including the semi-quantitative scoring of steatosis (S), activity (A) and fibrosis (F). Based on the algorithm, 230 obese patients (34%) were categorized as NASH, 291 (43%) as NAFLD without NASH and 158 (23%) as not NAFLD. The activity score (ballooning + lobular inflammation) enabled discriminating NASH since all patients with NASH had A≤2 while no patients with A<2 had NASH. This score was closely correlated with both ALT and AST (p<0.0001, ANOVA). Comparison of transaminase levels between patients with normal liver and pure steatosis did not reveal significant differences thus lending support to the proposal not to include steatosis in the activity score but reporting it separately in the SAF score. In the validation series, the interobserver agreement for the diagnosis of NASH was excellent (κ =0.80) between liver pathologists. There was no discrepancy between the initial diagnosis and the diagnosis proposed using the algorithm. In conclusion, we propose a simple but robust algorithm for categorizing liver lesions in NAFLD patients. Since liver lesions in obese patients may display a continuous spectrum of histologic lesions, we suggest describing liver lesions using the SAF score. (HEPATOLOGY 2012.).
Assistance Publique-Hôpitaux de Paris, Beaujon Hospital, Pathology Department, Clichy, F-92110 France; Centre de Recherche Bichat-Beaujon, INSERM U773, University Paris-Diderot, Paris, France. firstname.lastname@example.org.
This article was published in the following journal.
Name: Hepatology (Baltimore, Md.)
Cystic formations within the liver are a frequent finding among populations. Besides the common cystic lesions, like simple liver cysts, rare cystic liver lesions like cystadenocarcinoma should also b...
18F-fluorodeoxyglucose (FDG) PET/CT is invaluable in managing liver lesions, in particular in the evaluation of suspected liver metastases. It is both sensitive and specific in detecting liver metasta...
The aim of this study was to establish a clinical scoring formula of liver injury (SFLI) using the matter element analysis method, in order to provide the necessary information for the preoperative as...
To evaluate a computer-aided diagnosis (CADx) system for the characterization of liver lesions in computed tomography (CT) scans. The stand-alone predictive performance of the CADx system was assessed...
Limit of donor age, graft size and model for end-stage liver disease (MELD) score has not been apparent in living donor liver transplantation (LDLT). Our team has developed the following formula for p...
To determine the optimal dose of DMP 115 to image liver lesions and to assess whether contrast can improve the detection of focal liver lesions.
Acquire CT data and US and transducer position data (magnetic sensor system) of focal hepatic or renal lesions to serve as sample data sets for fusion algorithm development and subsequent...
This is a multicenter, randomized, open-label study to investigate the superiority of the contrast enhancement effect of E7337 on tumor-like lesions in the Dynamic CT of the liver.
The conventional sonography is frequently used to detect incidental focal liver lesions because of its availability, innocuity and low cost. Nevertheless, sensibility and specificity of co...
The Medtronic InSync III Marquis Cardiac Resynchronization Therapy Defibrillator (CRT-D)-System (implantable cardioverter-defibrillator with biventricular stimulation for cardiac resynchro...
Medical and Biotech [MESH] Definitions
An acronym for Acute Physiology and Chronic Health Evaluation, a scoring system using routinely collected data and providing an accurate, objective description for a broad range of intensive care unit admissions, measuring severity of illness in critically ill patients.
A noninvasive diagnostic technique that enables an experienced clinician to perform direct microscopic examination of the surface and architecture of pigmented SKIN lesions. The four major dermoscopic criteria are ABCD: asymmetry (A), borders (B), colors (C), and different structural components (D) providing a semiquantitative scoring system for each lesion.
Personality evaluation based on the scoring of several variables as a result of the subject's responses in perceiving 47 inkblot plates.
Tabular numerical representations of sequence motifs displaying their variability as likelihood values for each possible residue at each position in a sequence. Position-specific scoring matrices (PSSMs) are calculated from position frequency matrices.
Infection of the LIVER with species of MYCOBACTERIUM, most often MYCOBACTERIUM TUBERCULOSIS. It is characterized by localized small tuberculous miliary lesions or tumor-like mass (TUBERCULOMA), and abnormalities in liver function tests.