title: Morphometric assessment of liver fibrosis may enhance early diagnosis of biliary atresia.
abstract: BACKGROUND
  Neonatal cholestasis syndrome is considered as a major challenge in pediatric practice. This study was undertaken to investigate the value of morphometric assessment of hepatic fibrosis in early diagnosis of biliary atresia.
  
  
  METHODS
  We studied liver biopsy specimens from 53 patients with neonatal cholestasis. The patients were assigned to two groups: group 1 (25 patients with biliary atresia) and group 2 (28 patients with non-obstructive cholestasis). Morphometric assessment of fibrosis was performed for all biopsies; in addition, another twelve histological parameters were estimated and scored on a scale of 0 to 4. Biopsies of infants aged 60 days or younger were characterized and analyzed separately.
  
  
  RESULTS
  Morphometric value of fibrosis was significantly higher in group 1 than in group 2 (16.8 ± 8.4% vs. 5.9 ± 2.3%, respectively; P<0.001). By multiple regression analysis, bile ductular plugs, morphometric assessment of fibrosis, rosetting, portal tract inflammation and pattern of cholestasis were found to be significant in discriminating the two groups. In infants aged 60 days or younger, a cutoff value for morphometric assessment of fibrosis of 7.5% was the discriminating point between the two groups with a sensitivity of 80% and a specificity of 84%.
  
  
  CONCLUSIONS
  Morphometric assessment of hepatic fibrosis could enhance the value of liver biopsy in early diagnosis of biliary atresia.
authors.affiliation: Pediatric Gastroenterology and Hepatology Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed F
authors.initials: AF
authors.lastname: Abdalla
authors.forename: Abeer
authors.initials: A
authors.lastname: Fathy
authors.forename: Khaled R
authors.initials: KR
authors.lastname: Zalata
authors.forename: Ahmed
authors.initials: A
authors.lastname: Megahed
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abo-Alyazeed
authors.forename: Mohammed Ezz
authors.initials: ME
authors.lastname: El Regal
mesh_terms: D001656:Biliary Atresia / Q000175:diagnosis*; D001706:Biopsy; D002779:Cholestasis / Q000473:pathology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D015999:Multivariate Analysis; D012680:Sensitivity and Specificity