Relationship between clinical and pathologic findings in patients with chronic liver diseases.

AIM To explore the relationship between clinical findings of patients with chronic liver diseases and the pathologic grading and staging of liver tissues. METHODS The inflammatory activity and fibrosis of consecutive liver biopsies from 200 patients were determined according to the diagnosis criteria of chronic hepatitis in China established in 1995. A comparative analysis was carried out for 200 patients with chronic liver diseases by comparing their clinical manifestations, serum biochemical markers with the grading and staging of liver tissues. RESULTS It was revealed that age, index of clinical symptoms and physical signs were obviously relevant to the pathologic grading and staging of liver tissues (P<0.05). Blood platelet, red blood cells, aspartate aminotransferase (AST), N-terminal procollagen III (PIII NP) were apparently correlated with the degree of inflammation. PGA (prothrombin time, GGT, apoprotein A1) index, PGAA (PGA+delta2-macroglobulin) index, albumin and albumin/globulin were relevant to both inflammation and fibrosis. Hyaluronic acid (HA) was an accurate variable for the severity of hepatic inflammation and fibrosis. The combination of serum markers for fibrosis could increase the diagnostic accuracy. It was notable that viral replication markers were not relevant to the degree of inflammation and fibrosis. CONCLUSION There is a good correlation between clinical findings and the pathologic grading and staging of liver tissues, which may give aid to the noninvasive diagnosis of liver fibrosis.

[1]  D. Schuppan,et al.  Serum procollagen peptides and collagen type VI for the assessment of activity and degree of hepatic fibrosis in schistosomiasis and alcoholic liver disease , 1992, Hepatology.

[2]  C. Chu,et al.  Serum carboxy terminal propeptide of type I procollagen to amino terminal propeptide of type III procollagen ratio is a better indicator than each single propeptide and 7S domain type IV collagen for progressive fibrogenesis in chronic viral liver diseases , 2005, Digestive Diseases and Sciences.

[3]  D Chappard,et al.  Histopathological evaluation of liver fibrosis: quantitative image analysis vs semi-quantitative scores. Comparison with serum markers. , 1998, Journal of hepatology.

[4]  D. Hartmann,et al.  Serum laminin and type IV collagen are accurate markers of histologically severe alcoholic hepatitis in patients with cirrhosis. , 2000, Journal of hepatology.

[5]  Rifaat Safadi,et al.  Treatment of hepatic fibrosis: Almost there , 2003, Current gastroenterology reports.

[6]  S. Friedman,et al.  Hepatic fibrosis. Pathogenesis and principles of therapy , 2001 .

[7]  P. Bedossa,et al.  Noninvasive diagnosis of hepatic fibrosis or cirrhosis. , 1997, Gastroenterology.

[8]  D. Rockey The cell and molecular biology of hepatic fibrogenesis. Clinical and therapeutic implications. , 2000, Clinics in liver disease.

[9]  M. Tsutsumi,et al.  Serum markers for hepatic fibrosis in alcoholic liver disease: which is the best marker, type III procollagen, type IV collagen, laminin, tissue inhibitor of metalloproteinase, or prolyl hydroxylase? , 1996, Alcoholism, clinical and experimental research.

[10]  J. Rodés,et al.  Serum hyaluronate reflects hepatic fibrogenesis in alcoholic liver disease and is useful as a marker of fibrosis , 1996, Hepatology.

[11]  T. Poynard,et al.  Biochemical Markers of Fibrosis in Patients with Chronic Hepatitis C: A Comparison with Prothrombin Time, Platelet Count, and Age–Platelet Index , 2004, Digestive Diseases and Sciences.

[12]  S. Friedman,et al.  Liver fibrogenesis and the role of hepatic stellate cells: New insights and prospects for therapy , 1999, Journal of gastroenterology and hepatology.

[13]  P. Bedossa,et al.  Ultrasonographic diagnosis of hepatic fibrosis or cirrhosis. , 1999, Journal of hepatology.

[14]  D. Brenner,et al.  New aspects of hepatic fibrosis. , 2000, Journal of hepatology.

[15]  T. Poynard,et al.  Biochemical markers of liver fibrosis in patients with hepatitis C virus infection: a prospective study , 2001, The Lancet.

[16]  P. Mathurin,et al.  Prothrombin index decrease: a useful and reliable marker of extensive fibrosis? , 2002, European journal of gastroenterology & hepatology.

[17]  D. Schuppan,et al.  Serum Collagen Type VI and XIV and Hyaluronic Acid as Early Indicators for Altered Connective Tissue Turnover in Alcoholic Liver Disease , 2001, Digestive Diseases and Sciences.

[18]  T. Poynard,et al.  Biochemical markers of liver fibrosis: a comparison with historical features in patients with chronic hepatitis C , 2002, American Journal of Gastroenterology.

[19]  D. Sherman,et al.  Comparison of serum procollagen III peptide concentrations and PGA index for assessment of hepatic fibrosis , 1993, The Lancet.

[20]  D. Thabut,et al.  Noninvasive prediction of fibrosis in patients with chronic hepatitis C , 2003, Hepatology.

[21]  R. Fontana,et al.  Noninvasive monitoring of patients with chronic hepatitis C , 2002, Hepatology.

[22]  M. Pirisi,et al.  A Comparison of Four Serum Markers of Fibrosis in the Diagnosis of Cirrhosis , 1997, Annals of clinical biochemistry.

[23]  L. Serfaty,et al.  Diagnostic accuracy of hyaluronan and type III procollagen amino-terminal peptide serum assays as markers of liver fibrosis in chronic viral hepatitis C evaluated by ROC curve analysis. , 1996, Clinical chemistry.

[24]  H. Weng,et al.  Determination of serum fibrosis indexes in patients with chronic hepatitis and its significance. , 2003, Chinese medical journal.

[25]  F. Capron,et al.  [Biological diagnosis of the type of liver disease in alcoholic patients with abnormal liver function tests]. , 1999, Gastroenterologie clinique et biologique.

[26]  H. Kawasaki,et al.  Diagnostic value of serum markers of connective tissue turnover for predicting histological staging and grading in patients with chronic hepatitis C , 2001, Journal of Gastroenterology.

[27]  Rong-hua Liu,et al.  ROC curves in evaluation of serum fibrosis indices for hepatic fibrosis. , 2002, World journal of gastroenterology.

[28]  M. Manns,et al.  Serum hyaluronate and type III procollagen aminoterminal propeptide concentration in chronic liver disease. Relationship to cirrhosis and disease activity , 1991, European journal of clinical investigation.

[29]  S. Ukabam,et al.  Quantitative assessment of fibrosis and steatosis in liver biopsies from patients with chronic hepatitis C , 2001, Journal of clinical pathology.

[30]  S. Pol,et al.  PGA score In diagnosis of alcoholic fibrosis , 1994, The Lancet.

[31]  R. N. Macsween,et al.  Comparison of assays for N-amino terminal propeptide of type III procollagen in chronic hepatitis C by using receiver operating characteristic analysis. , 1999, European journal of gastroenterology & hepatology.

[32]  H. C. Jiang,et al.  Advances in gene therapy of liver cirrhosis: a review. , 2001, World journal of gastroenterology.

[33]  D. Chappard,et al.  Prothrombin index is an indirect marker of severe liver fibrosis , 2002, European journal of gastroenterology & hepatology.

[34]  P. Rampal,et al.  Non invasive prediction of severe fibrosis in patients with alcoholic liver disease. , 2000, Gastroenterologie clinique et biologique.

[35]  Xiong Cai,et al.  Grading and staging of hepatic fibrosis, and its relationship with noninvasive diagnostic parameters. , 2003, World journal of gastroenterology.

[36]  G. Labbadia,et al.  Liver Fibrosis: What's the Beginning of Autonomic Deficit? , 2002, Scandinavian journal of gastroenterology.