title: Histological grading and staging in chronic hepatitis: its practical correlation.
abstract: Although the histological features of various causes of chronic liver disease have been well described, usually the inflammatory activity of the disease is important after the cause has been established. Some patients have co-infection or concomitant liver disease and on occasion it is difficult to decide the treatment. In order to clarify the histological differences, we investigated the inflammatory activity among autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), chronic hepatitis C (CHC) and chronic hepatitis B (CHB) in a standardized way using the modified histological activity index (HAI). According to the modified HAI, inflammatory activity is divided into four categories; categories A/D explains portal/periportal inflammation and categories B/C explains lobular activity. The inflammatory score of AIH tended to be greater in all categories from the early stage of fibrosis, whereas scores of PBC were lower, except for portal inflammation. Chronic hepatitis C patients had portal or periportal inflammation, and their inflammatory scores were linked to the development of fibrosis. Chronic hepatitis B patients tended to have severe lobular injury, but did not have a relationship between the inflammatory score and their stage. To know the distribution of inflammation using the modified HAI scoring system may be helpful and convenient in evaluating patients with chronic inflammatory liver disease.
authors.affiliation: Division of Surgical Pathology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Nakaji
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yano
authors.forename: Seitetu
authors.initials: S
authors.lastname: Yoon
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Seo
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Nagano
authors.forename: Hideshi
authors.initials: H
authors.lastname: Komori
authors.forename: Kimio
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Akio
authors.initials: A
authors.lastname: Orino
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Shirane
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yokozaki
authors.forename: Masato
authors.initials: M
authors.lastname: Kasuga
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000974:Antibodies, Antinuclear / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D005260:Female; D019694:Hepatitis B, Chronic / Q000097:blood / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000097:blood / Q000473:pathology; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000473:pathology; D006521:Hepatitis, Chronic / Q000097:blood / Q000145:classification / Q000473:pathology*; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000276:immunology; D009336:Necrosis; D011168:Portal System / Q000473:pathology
chemical_list: D000974:Antibodies, Antinuclear; D004279:DNA, Viral; D000410:Alanine Transaminase