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Systematic quantification of histological patterns shows accuracy in reflecting cirrhotic remodeling
Author(s) -
Wang Yan,
Huang Wei,
Li Ruhua,
Yun Zhaoqiang,
Zhu Youfu,
Yang Jinlian,
Liu Hailin,
Liu Zhipeng,
Feng Qianjin,
Hou Jinlin
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13722
Subject(s) - medicine , cirrhosis , receiver operating characteristic , pathology , chronic hepatitis , gastroenterology , radiology , nuclear medicine , virus , virology
Background and Aim There still lacks a tool for precisely evaluating cirrhotic remodeling. Histologic distortion characterized in cirrhosis (i.e. cirrhotic patterns) has a validated pathophysiological meaning and potential relevance to clinical complications. We aimed to establish a new tool to quantify the cirrhotic patterns and test it for reflecting the cirrhotic remodeling. Methods We designed a computerized algorithm, named q CP, dedicated for the analysis of liver images acquired by second harmonic microscopy. We evaluated its measurement by using a cohort of 95 biopsies (Ishak staging F4/5/6 = 33/35/27) of chronic hepatitis B and a carbon tetrachloride‐intoxicated rat model for simulating the bidirectional cirrhotic change. Results Q CP can characterize 14 histological cirrhosis parameters involving the nodules, septa, sinusoid, and vessels. For chronic hepatitis B biopsies, the mean overall intra‐observer and inter‐observer agreement was 0.94 ± 0.08 and 0.93 ± 0.09, respectively. The robustness in resisting sample adequacy‐related scoring error was demonstrated. The proportionate areas of total (collagen proportionate area), septal (septal collagen proportionate area [SPA]), sinusoidal, and vessel collagen, nodule area, and nodule density (ND) were associated with Ishak staging ( P < 0.01 for all). But only ND and SPA were independently associated ( P ≤ 0.001 for both). A histological cirrhosis parameters‐composed q CP‐index demonstrated an excellent accuracy in quantitatively diagnosing evolving cirrhosis (areas under receiver operating characteristic curves 0.95–0.92; sensitivity 0.93–0.82; specificity 0.94–0.85). In the rat model, changes in collagen proportionate area, SPA, and ND had strong correlations with both cirrhosis progression and regression and faithfully characterized the histological evolution. Conclusions Q CP preliminarily demonstrates potential for quantitating cirrhotic remodeling with high resolution and accuracy. Further validation with in‐study cohorts and multiple‐etiologies is warranted.