Formation and evalution of numerical scoring parameters for assessing histological activity in various viral hepatitis

Abstract

AIM: To evaluate the diagnostic parameters of characteristic pathologic change in the liver biopsy specimens, we developed a numerical scoring diagnostic standard.

METHODS: Ten of the eleven categories of characteristic pathologic lessions appearing in acute hepatitis and 11 categories in chronic hepatitis were selected. Each of them was graded 3 scales, then the essential score and scale score were set up. Adding up to all the numerical scores of in dividual components, formed the total scores of histological chronic activity index (HCAI) and histological acute activity index (HAAI). One thousand and eight patients with various liver diseases were studied, and compared with conventional readings and Knodell’HAI through F analysis and q test.

RESULTS: The HAAI of acute, subacute, and chronic severe hepatitis was 43.56 ± 9.08, 51.63 ± 12.13, and 65.45 ± 17.51 respectively. There was significant difference between each other (P < 0.01). Their HCAI was 14.44 ± 8.31, 57.39 ± 10.98, and 58.14 ± 12.24 respectively. HAAI of mild, moderate, and severe chronic hepatitis was 18.57 ± 7.00, 26.43 ± 7.49, and 35.58 ± 11.47 respectively (P < 0.01), and HCAI was 13.2 ± 6.90, 40.29 ± 10.99, and 50.02 ± 9.78 respectively. There was significant difference (P < 0.01). The HAAI of active liver cirrhosis and silent liver cirrhosis was 64.96 ± 16.60 and 31.17 ± 9.07 respectively, the difference being significant (P < 0.01), and HCAI was 66.00 ± 9.62 and 69.84 ± 8.93, with no significant difference (P > 0.05).

CONCLUSION: The diagnostic standard of histological activity index that we set up, was more useful as either an alternative or supplement to the conventional terminology and Knodell’HAI.

Key Words: Hepatitis viruses; Biospy; Histology; Histological chronic activity index; Histological acute activity index