Characteristics of perisinusoidal collagenization in liver cirrhosis: computer-assisted quantitative analysis.
OBJECTIVE
To determine the respective roles of septal fibrosis, necroinflammatory activity, iron deposition, steatosis, and patterns of nodular and septal remodeling in the collagenization of the perisinusoidal space in livers from patients undergoing transplantation for alcoholic or posthepatitis C cirrhosis and to ascertain whether perisinusoidal collagenization has clinical implications added to those of septal fibrosis.


METHODS
Sixty-six hepatectomy specimens from patients undergoing liver transplantation for cirrhosis were analyzed. Thirty-two alcoholic and 34 posthepatitis C cirrhoses were included. Picro Sirius-stained slides were examined with polarized light and the amount of perisinusoidal collagenization measured by computerized image analysis. Size distributions of septa and nodules were assessed by mathematical morphology methods.


RESULTS
The septal and perisinusoidal fibrosis indices and Knodell and Pugh-Child scores showed significant differences between alcoholic and posthepatitis cirrhoses. Correlation between septal fibrosis and perisinusoidal collagenization was weak, though significant. Both variables correlated significantly with the clinical score. The correlation was negative between septal fibrosis or perisinusoidal collagenization and the Knodell score.


CONCLUSIONS
Perisinusoidal collagenization was not a feature of all cases of cirrhosis, although it was more prominent in alcoholics. For the whole series, it significantly correlated with the clinical score, which increased significantly when high perisinusoidal collagenization was added to high septal fibrosis. No absolute dependence was found between perisinusoidal collagenization and septal fibrosis; percentage of slender fibrous septa and amount of iron deposition were other factors entered in the regression equation.
Moragas
A
A
Department of Anatomic Pathology, Hospitals Universitaris Vall d'Hebron, Barcelona, Spain.
Allende
H
H
Sans
M
M
D000328:Adult; D000368:Aged; D003094:Collagen / Q000378:metabolism*; D005260:Female; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008103:Liver Cirrhosis / Q000209:etiology / Q000378:metabolism* / Q000473:pathology*; D008104:Liver Cirrhosis, Alcoholic / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D016031:Liver Transplantation / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013194:Staining and Labeling
D003094:Collagen