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Regression of liver fibrosis in cases of chronic liver disease type C: quantitative evaluation by using computed
Makoto Arima1, Hideo Terao, Kenji Kashima
1Department of Infectious Diseases, Oita University, Oita 879-5593.
Insights
Quantitative analysis of liver fibrosis area confirms significant regression after Hepatitis C virus (HCV) eradication with interferon (IFN) therapy. This method offers superior detail compared to traditional scoring systems for assessing fibrosis changes.
Area of Science:
- Hepatology
- Virology
- Digital Pathology
Background:
- Liver fibrosis is a hallmark of chronic liver disease, often assessed by scoring systems.
- Traditional scoring may not capture subtle fibrosis reductions after treatment.
- Hepatitis C virus (HCV) infection is a major cause of chronic liver disease and fibrosis.
Purpose of the Study:
- To quantitatively assess liver fibrosis changes using digital image analysis.
- To compare the detailed change in fibrosis area with classical staging.
- To evaluate fibrosis regression in patients with HCV after interferon (IFN) therapy.
Main Methods:
- Digital image analysis was used to measure the area of fibrosis in liver biopsy samples.
- The study included 25 patients with HCV infection: 20 with complete response (CR) to IFN and 5 on conservative therapy (CT).
- Fibrosis area rate was calculated relative to the total biopsied liver tissue.
Main Results:
- In the CR group, the fibrosis rate significantly regressed from 7.2 ± 1.5% before therapy to 2.7 ± 0.5% after therapy.
- In the CT group, the fibrosis rate increased from 8.4 ± 4.3% at the first biopsy to 15.9 ± 7.7% at the second biopsy.
- Quantitative analysis revealed significant fibrosis regression in patients achieving viral eradication.
Conclusions:
- Regression of liver fibrosis can be confirmed in patients with virologic response to IFN, including those with liver cirrhosis.
- Quantitative fibrosis area measurement provides superior information compared to classical staging.
- Digital image analysis is a valuable tool for detailed assessment of liver fibrosis dynamics.
Object:
It was reported that the liver fibrosis is reduced in patients with chronic liver disease type C after eradication of HCV. Degree of fibrosis was expressed by the classical fibrosis scoring system (F0-F4) at present. However a change of subtle reduction of fibrosis cannot be expressed in its fibrosis score and thus we measured an area of fibrosis and compared detailed change of the fibrosis area in paired liver biopsy.
Methods:
For quantitative assessment of liver fibrosis, we measured an area of fibrosis using computed digital image analysis and pursued the rate of a fibrosis area for whole biopsied liver tissue of 25 patients with HCV infection (20 complete response patients to IFN therapy who showed viral eradication: CR and 5 non-treated ones with IFN but had conservative therapy: CT).
Results:
In CR group, fibrosis rate was 7.2 +/- 1.5% before therapy, 2.7 +/- 0.5% after the therapy and they were significantly regressed. In CT group, fibrosis rate was 8.4 +/- 4.3% at the first biopsy, 15.9 +/- 7.7% at the second biopsy.
Conclusions:
Regression of liver fibrosis could be confirmed in patients with virologic response to IFN even in patients with liver cirrhosis. Our quantitative evaluation provided information superior to that obtained by the classical fibrosis staging score system.
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