Liver biopsy evaluation in chronic hepatitis b infection: ‘Back to basics’ - re-visiting semi-quantitative scoring systems
Journal Title: IP Archives of Cytology and Histopathology Research - Year 2018, Vol 3, Issue 3
Abstract
Context Despite advances in understanding into the pathophysiology of chronic hepatitis B liver biopsy evaluation on HE stained sections has stood the test of time There is therefore a need to revisit the most commonly used scoring systems with an aim to look for an ideal semiquantitative system which is objective simple to apply and versatile enough to incorporate newer advancesAims To compare various semiquantitative scoring systems with a view to a look for consistency in reporting b assess usefulness in followup and c recommend a scoring system that is practical and easy to applySettings and Design Chronic hepatitis B was defined as HBsAg positive status for at least six months All liver biopsies were evaluated using semiquantitative scoring systems viz the Knodell Ishaks modified HAI and Scheuer systemsMaterials and Methods Baseline biopsies were assessed for intra and interobserver variation in order to find the system best suited for routine use The observer variation was also calculated separately for portal periportal and lobular inflammation as well as for fibrosisStatistical Analysis used A Kappa analysis up to 95 confidence intervalwas done to look for statistical significance of inter and intraobserver agreement between the three scoring systemsResults On multivariate Kappa analysis it was found that both inter and intraobserver agreement were comparable in the Knodell and Ishak systems and was significantly better with the Scheuer system Further agreement was better with fibrosis than with necroinflammatory scoresConclusions The authors recommend Ishaks modified system as it conveyed the most relevant and exhaustive information Keywords Chronic hepatitis B Ishaks system Knodells system Liver biopsy Scheuer system Semiquantitative scoring systems
Authors and Affiliations
Aneeta Jassar, V K Kumar
Keywords
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- EP ID EP490573
- DOI 10.18231/2456-9267.2018.0026
- Views 122
- Downloads 0
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