Cargando…
A scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy
BACKGROUND: Liver biopsy is the essential method to diagnose non-alcoholic steatohepatitis (NASH), but histological features of NASH are too subjective to achieve reproducible diagnoses in early stages of disease. We aimed to identify the key histological features of NASH and devise a scoring model...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Pathologists and the Korean Society for Cytopathology
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253961/ https://www.ncbi.nlm.nih.gov/pubmed/32460476 http://dx.doi.org/10.4132/jptm.2020.03.07 |
_version_ | 1783539434002579456 |
---|---|
author | Lee, Kyoungbun Jung, Eun Sun Yu, Eunsil Kang, Yun Kyung Cho, Mee-Yon Kim, Joon Mee Moon, Woo Sung Jeong, Jin Sook Park, Cheol Keun Park, Jae-Bok Kang, Dae Young Sohn, Jin Hee Jin, So-Young |
author_facet | Lee, Kyoungbun Jung, Eun Sun Yu, Eunsil Kang, Yun Kyung Cho, Mee-Yon Kim, Joon Mee Moon, Woo Sung Jeong, Jin Sook Park, Cheol Keun Park, Jae-Bok Kang, Dae Young Sohn, Jin Hee Jin, So-Young |
author_sort | Lee, Kyoungbun |
collection | PubMed |
description | BACKGROUND: Liver biopsy is the essential method to diagnose non-alcoholic steatohepatitis (NASH), but histological features of NASH are too subjective to achieve reproducible diagnoses in early stages of disease. We aimed to identify the key histological features of NASH and devise a scoring model for diagnosis. METHODS: Thirteen pathologists blindly assessed 12 histological factors and final histological diagnoses (‘not-NASH,’ ‘borderline,’ and ‘NASH’) of 31 liver biopsies that were diagnosed as non-alcoholic fatty liver disease (NAFLD) or NASH before and after consensus. The main histological parameters to diagnose NASH were selected based on histological diagnoses and the diagnostic accuracy and agreement of 12 scoring models were compared for final diagnosis and the NAFLD Activity Score (NAS) system. RESULTS: Inter-observer agreement of final diagnosis was fair (κ = 0.25) before consensus and slightly improved after consensus (κ = 0.33). Steatosis at more than 5% was the essential parameter for diagnosis. Major diagnostic factors for diagnosis were fibrosis except 1C grade and presence of ballooned cells. Minor diagnostic factors were lobular inflammation (≥ 2 foci/ × 200 field), microgranuloma, and glycogenated nuclei. All 12 models showed higher inter-observer agreement rates than NAS and post-consensus diagnosis (κ = 0.52–0.69 vs. 0.33). Considering the reproducibility of factors and practicability of the model, summation of the scores of major (× 2) and minor factors may be used for the practical diagnosis of NASH. CONCLUSIONS: A scoring system for the diagnosis of NAFLD would be helpful as guidelines for pathologists and clinicians by improving the reproducibility of histological diagnosis of NAFLD. |
format | Online Article Text |
id | pubmed-7253961 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The Korean Society of Pathologists and the Korean Society for Cytopathology |
record_format | MEDLINE/PubMed |
spelling | pubmed-72539612020-06-08 A scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy Lee, Kyoungbun Jung, Eun Sun Yu, Eunsil Kang, Yun Kyung Cho, Mee-Yon Kim, Joon Mee Moon, Woo Sung Jeong, Jin Sook Park, Cheol Keun Park, Jae-Bok Kang, Dae Young Sohn, Jin Hee Jin, So-Young J Pathol Transl Med Original Article BACKGROUND: Liver biopsy is the essential method to diagnose non-alcoholic steatohepatitis (NASH), but histological features of NASH are too subjective to achieve reproducible diagnoses in early stages of disease. We aimed to identify the key histological features of NASH and devise a scoring model for diagnosis. METHODS: Thirteen pathologists blindly assessed 12 histological factors and final histological diagnoses (‘not-NASH,’ ‘borderline,’ and ‘NASH’) of 31 liver biopsies that were diagnosed as non-alcoholic fatty liver disease (NAFLD) or NASH before and after consensus. The main histological parameters to diagnose NASH were selected based on histological diagnoses and the diagnostic accuracy and agreement of 12 scoring models were compared for final diagnosis and the NAFLD Activity Score (NAS) system. RESULTS: Inter-observer agreement of final diagnosis was fair (κ = 0.25) before consensus and slightly improved after consensus (κ = 0.33). Steatosis at more than 5% was the essential parameter for diagnosis. Major diagnostic factors for diagnosis were fibrosis except 1C grade and presence of ballooned cells. Minor diagnostic factors were lobular inflammation (≥ 2 foci/ × 200 field), microgranuloma, and glycogenated nuclei. All 12 models showed higher inter-observer agreement rates than NAS and post-consensus diagnosis (κ = 0.52–0.69 vs. 0.33). Considering the reproducibility of factors and practicability of the model, summation of the scores of major (× 2) and minor factors may be used for the practical diagnosis of NASH. CONCLUSIONS: A scoring system for the diagnosis of NAFLD would be helpful as guidelines for pathologists and clinicians by improving the reproducibility of histological diagnosis of NAFLD. The Korean Society of Pathologists and the Korean Society for Cytopathology 2020-05 2020-04-15 /pmc/articles/PMC7253961/ /pubmed/32460476 http://dx.doi.org/10.4132/jptm.2020.03.07 Text en © 2020 The Korean Society of Pathologists/The Korean Society for Cytopathology This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Lee, Kyoungbun Jung, Eun Sun Yu, Eunsil Kang, Yun Kyung Cho, Mee-Yon Kim, Joon Mee Moon, Woo Sung Jeong, Jin Sook Park, Cheol Keun Park, Jae-Bok Kang, Dae Young Sohn, Jin Hee Jin, So-Young A scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy |
title | A scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy |
title_full | A scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy |
title_fullStr | A scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy |
title_full_unstemmed | A scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy |
title_short | A scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy |
title_sort | scoring system for the diagnosis of non-alcoholic steatohepatitis from liver biopsy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253961/ https://www.ncbi.nlm.nih.gov/pubmed/32460476 http://dx.doi.org/10.4132/jptm.2020.03.07 |
work_keys_str_mv | AT leekyoungbun ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT jungeunsun ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT yueunsil ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT kangyunkyung ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT chomeeyon ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT kimjoonmee ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT moonwoosung ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT jeongjinsook ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT parkcheolkeun ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT parkjaebok ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT kangdaeyoung ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT sohnjinhee ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT jinsoyoung ascoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT leekyoungbun scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT jungeunsun scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT yueunsil scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT kangyunkyung scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT chomeeyon scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT kimjoonmee scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT moonwoosung scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT jeongjinsook scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT parkcheolkeun scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT parkjaebok scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT kangdaeyoung scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT sohnjinhee scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy AT jinsoyoung scoringsystemforthediagnosisofnonalcoholicsteatohepatitisfromliverbiopsy |