title: Collagen proportionate area of liver tissue determined by digital image analysis in patients with HBV-related decompensated cirrhosis.
abstract: BACKGROUND
  The accurate assessment of the degree of hepatic fibrosis plays a critical role in guiding the diagnosis, treatment and prognostic assessment of chronic liver diseases. Liver biopsy is currently the most reliable method to evaluate the severity of hepatic fibrosis. However, liver biopsy is an invasive procedure associated with morbidity and mortality, and has several limitations in patients with decompensated cirrhosis. There is no report on the collagen proportionate area (CPA) of liver tissue in the decompensated stage of cirrhosis. This study aimed to determine the CPA of resected liver tissue samples from patients with HBV-related decompensated cirrhosis using digital image analysis, and to analyze the relationship between the CPA and liver functional reserve.
  
  
  METHODS
  Fifty-three resected liver tissue samples from liver transplant patients with chronic hepatitis B-induced decompensated cirrhosis were stained with Masson's trichrome, and the CPA in these samples was quantitatively determined using digital image analysis. The values of relevant liver function just before liver transplantation, the CPA in liver tissue, and their correlation were analyzed.
  
  
  RESULTS
  The mean CPA at the decompensated stage of cirrhosis was 35.93+/-14.42% (11.24%-63.41%). The correlation coefficients of the CPA with a model for end-stage liver disease score, serum total bilirubin and international standard ratio of prothrombin B were 0.553, 0.519 and 0.533, respectively (P<0.001). With increasing CPA values, the three indices reflecting liver functional reserve also changed significantly.
  
  
  CONCLUSIONS
  The degree of fibrosis may be correlated with the functional reserve. With the advancement of fibrosis, the liver functional reserve is attenuated accordingly.
authors.affiliation: Department of Infectious Disease, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China. xieshibin2002@yahoo.com.cn
authors.forename: Shi-Bin
authors.initials: SB
authors.lastname: Xie
authors.forename: Chao
authors.initials: C
authors.lastname: Ma
authors.forename: Chao-Shuang
authors.initials: CS
authors.lastname: Lin
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.forename: Jian-Yun
authors.initials: JY
authors.lastname: Zhu
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Ke
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001391:Azo Compounds; D015415:Biomarkers / Q000032:analysis; D002681:China; D003094:Collagen / Q000032:analysis*; D004396:Coloring Agents; D004801:Eosine Yellowish-(YS); D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D019934:International Normalized Ratio; D016014:Linear Models; D008099:Liver / Q000737:chemistry* / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery / Q000821:virology; D008111:Liver Function Tests; D016031:Liver Transplantation; D008297:Male; D008739:Methyl Green; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013194:Staining and Labeling / Q000379:methods*
chemical_list: D001391:Azo Compounds; D015415:Biomarkers; D004396:Coloring Agents; C017768:trichrome stain; D008739:Methyl Green; D003094:Collagen; D004801:Eosine Yellowish-(YS)