New concept in histopathological grading and staging of chronic hepatitis C infection at Sharkia Governorate, Egypt.
Hepatitis C virus (HCV) has been estimated by the WHO to infect 170 million patients worldwide, with a high prevalence rate (about 24.5%) among Egyptians. The disease could be presented with variable hepatic lesions ranging from mild inflammation, fibrosis, cirrhosis to even end stage liver disease and hepatocellular carcinoma. The Knodell histology activity index, published in 1981, was the first system of its type and is widely regarded as the benchmark for objective, semi-quantitative reproducible description of the various morphological lesions of chronic hepatitis. Other proposals for semi-quantitative evaluation have followed. In this study, when applying these systems on the present cases (109 liver biopsies taken from Egyptian patients infected with HCV), the authors found that the presented histopathological features may be unusual for any of the known scoring systems. Therefore, they suggested a new system for grading and staging of liver diseases in Egyptian patients infected with HCV. Accordingly, the degrees of necroinflammations are classified into 3 grades (1-3) and the progression of fibrosis is classified into 3 stages (1-3). The reduced numbers of grades and stages proposed in this study may be attributed to the rapid course among Egyptians who differ in environmental circumstances from abroad.
Mangoud
Amal M
AM
Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Eissa
Mostafa H
MH
Sabee
Essam I
EI
Ibrahem
Ibrahem A
IA
Ismail
Alaa
A
Morsy
Tosson A
TA
Nor Edin
Essam
E
Mostafa
Yousry
Y
Abuel-Magd
Yousry
Y
Afefy
Afefy F
AF
el-Shorbagy
Eman
E
el-Sadawy
Mahmoud
M
Ragab
Hosnia
H
Mahrous
Seham
S
Abdel Menem
Amal
A
Etewa
Samia
S
Hassan
Mostafa I
MI
Lakouz
Khalid
K
Abdel-Aziz
Khalid
K
Saber
Mahmoud
M
el-Hady
Gaber
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004534:Egypt; D005260:Female; D019698:Hepatitis C, Chronic / Q000145:classification* / Q000473:pathology* / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000821:virology; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged