[Comparison of the different methods of grading and staging of chronic hepatitis]

In the recent literature it has been emerged the importance of grading and staging of chronic viral hepatitis. Numerous different methods of grading and staging have been proposed. Purpose of the present paper was to compare the methods proposed by Knodell et al., Scheuer, and Ishak et al.

Forty consecutive cases of chronic viral hepatitis constituted the basis of the study. Each case was graded as mild, moderate and severe activity and staged according to the criteria described in the three methods. In particular portal-periportal activity, lobular activity and fibrosis were evaluated. The final evaluation of the liver biopsy, together with the result of each single feature, were then compared.

The three different methods gave grossly similar results in the overall grading of the cases. Analyzing the single features, differences were noted in the evaluation of the lobular activity. This is probably the consequence of the different qualitative and quantitative criteria applied. Comparison of the data obtained by evaluating the extension of fibrosis was quite difficult, owing to the extremely different scales of grading used in each single method.

In this study three different methods of grading and staging of chronic viral hepatitis were compared. The final evaluations of the cases obtained with the different methods were almost superimposable. Comparing the data obtained with long term follow-up of the patients may better clarify which of the different methods can have a prognostic value.