title: Prognostic analysis in chronic hepatitis B patients: a retrospective study of 216 cases about Scheuer scores, in situ expression of viral antigens and tissue hepatitis B virus DNA levels.
abstract: BACKGROUND
  Most of the previous studies of patients with chronic hepatitis B virus (HBV) infection concentrated on serum samples. Liver biopsy specimens for HBV have not been systematically analyzed. This study was performed to analyze some histopathological indicators (Scheuer scores, the expression of HBV antigens in situ, HBV DNA quantification) in the biopsy samples and showed the relationship among them and the prognosis of chronic hepatitis.
  
  
  METHODS
  A total of 216 consecutive chronic HBV-infected patients were followed up by clinical and laboratory data and classified into two groups at first: carcinogenesis and non-carcinogenesis. The non-carcinogenesis also included two groups: cirrhosis and non-cirrhosis. The non-cirrhosis was still divided into fluctuation and normalization at last. Histological activity index was described by Scheuer scores. Two-step immunohistochemical staining showed the expression of viral antigens in situ. Tissue HBV DNA levels were determined by fluorescence quantitative real-time PCR.
  
  
  RESULTS
  Regression analysis revealed significant positive correlations between the expression of hepatitis B e antigen (HBeAg) and grading, as well as between hepatitis Bx (HBx) protein and grading or staging of Scheuer scores. Positive correlations between grading or staging and prognosis were statistically significant. The expressions of HBeAg and HBx protein were higher in patients with cirrhosis than those without cirrhosis. Scheuer score was the most important indicator of prognosis.
  
  
  CONCLUSIONS
  HBeAg and HBx protein can be used as indicators of hepatitis activity and their positive expressions increase the risk for cirrhosis remarkably. In addition to be a marker of liver damage, Scheuer score is the most reliable indicator of the prognosis.
authors.affiliation: Department of Pathology and Pathology Research Center, Shanghai Medical College, Shanghai, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhu
authors.forename: Hai
authors.initials: H
authors.lastname: Huang
authors.forename: Huiping
authors.initials: H
authors.lastname: Zhang
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Xiqi
authors.initials: X
authors.lastname: Hu
authors.forename: Weirong
authors.initials: W
authors.lastname: Zhai
authors.forename: Yuqin
authors.initials: Y
authors.lastname: Lin
authors.forename: Jiyao
authors.initials: J
authors.lastname: Wang
authors.forename: Hongguang
authors.initials: H
authors.lastname: Zhu
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D018450:Disease Progression; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000276:immunology* / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008103:Liver Cirrhosis / Q000473:pathology*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens