title: Evaluation of a new histologic staging and grading system for primary biliary cirrhosis in comparison with classical systems.
abstract: Recently, our research team proposed a new histologic staging and grading system for primary biliary cirrhosis (PBC) that takes into account necroinflammatory activity and histologic heterogeneity. The present study aimed to confirm the usefulness of the new evaluation system. A total of 152 liver biopsy specimens and clinical data (including outcomes in patients with PBC before treatment with ursodeoxycholic acid) were analyzed with respect to the new system. Staging was evaluated on the basis of 3 histologic components (fibrosis, bile duct loss, and deposition of orcein-positive granules), and grading was assessed on the basis of chronic cholangitis activity and hepatitis activity. Concurrently, the classical systems, that is, the Scheuer and Ludwig staging systems, were also assessed and compared with our new system. PBC cases showed different distributions in each stage of the 3 systems. The new staging and grading system reflected liver dysfunctions before specific treatment. This was on a par with the results obtained using the classical systems. Development of cirrhosis-related conditions correlated well with the new staging system compared with the 2 classical staging systems, and in particular, the amount of deposition of orcein-positive granules could reflect development of cirrhosis-related conditions (scores 0-1 versus scores 2-3 groups, P < .0001). In conclusion, the new PBC staging system was demonstrated to reflect clinicolaboratory features, and its progression was associated with the development of cirrhosis-related conditions.
authors: Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa 920-8640, Japan.
authors: Yuko
authors: Y
authors: Kakuda
authors: Kenichi
authors: K
authors: Harada
authors: Seiko
authors: S
authors: Sawada-Kitamura
authors: Hiroko
authors: H
authors: Ikeda
authors: Yasunori
authors: Y
authors: Sato
authors: Motoko
authors: M
authors: Sasaki
authors: Hirofumi
authors: H
authors: Okafuji
authors: Eishiro
authors: E
authors: Mizukoshi
authors: Shuichi
authors: S
authors: Terasaki
authors: Hajime
authors: H
authors: Ohta
authors: Satomi
authors: S
authors: Kasashima
authors: Atsuhiro
authors: A
authors: Kawashima
authors: Yasuharu
authors: Y
authors: Kaizaki
authors: Shuichi
authors: S
authors: Kaneko
authors: Yasuni
authors: Y
authors: Nakanuma
mesh_terms: D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000145:classification* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010338:Pathology, Clinical / Q000379:methods*