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  • Title: Histological subclassification of cirrhosis based on histological-haemodynamic correlation.
    Author: Kumar M, Sakhuja P, Kumar A, Manglik N, Choudhury A, Hissar S, Rastogi A, Sarin SK.
    Journal: Aliment Pharmacol Ther; 2008 May; 27(9):771-9. PubMed ID: 18284653.
    Abstract:
    BACKGROUND: Determining a relationship between specific histological parameters in cirrhosis and hepatic venous pressure gradient can be used to subclassify cirrhosis. AIM: To determine the relationship between hepatic venous pressure gradient and specific histological parameters in cirrhosis. METHODS: Forty-seven patients (mean age: 46.2 +/- 13.6 years; 36 male) with biopsy-proven cirrhosis and hepatic venous pressure gradient measurements within 1 month of biopsy were studied. The following histological parameters were scored semiquantitatively: nodule size, loss of portal tracts and central veins, portal inflammation, periportal inflammation, bile duct proliferation, lobular inflammation, ballooning, fatty change, cholestasis and septal thickness. RESULTS: On multiple ordinal regression analysis, small nodule size (odds ratio: 21.0; 95% confidence interval: 2.1-208.2, P = 0.009) and thick septa (OR: 42.6; CI: 2.3-783.7, P = 0.011) were significantly associated with the presence of clinically significant portal hypertension. A score was assigned to each of the two parameters (nodule size: large = 1, medium = 2, small = 3 and septal thickness: thin = 1, medium = 2, thick = 3). Two subcategories were devised based on the composite score: category A (n = 12): score 1-3 and category B (n = 35): score 4-6. On ordinal regression, subcategory B (OR: 15.5; CI: 3.3-74.2, P = 0.001) was significantly associated with clinically significant portal hypertension. CONCLUSION: Small nodularity and thick septa are independent predictors of the presence of clinically significant portal hypertension.
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