title: Primary sclerosing cholangitis: detailed histologic assessment and integration using bioinformatics highlights arterial fibrointimal hyperplasia as a novel feature.
abstract: OBJECTIVE
  Liver biopsy diagnosis of primary sclerosing cholangitis (PSC) is difficult. We performed a detailed histologic analysis of PSC cases using novel bioinformatics analysis to identify histologic features that may be useful in its diagnosis.
  
  
  METHODS
  PSC liver explants were examined and compared with primary biliary cirrhosis and hepatitis C explants to act as controls. Demographic, macroscopic, and histologic variables were analyzed using both conventional statistics and an integrative bioinformatics approach, significance analysis of microarrays (SAM), and hierarchical clustering analysis (HCA).
  
  
  RESULTS
  The PSC group was younger and had distinctive PSC features, including bile duct scars, onion-skin fibrosis, and arterial fibrointimal hyperplasia. SAM allowed the integration of variables by comparing PSC and control groups, whereas HCA was able to correctly categorize each group.
  
  
  CONCLUSIONS
  This study demonstrates characteristic PSC histology as well as arterial hyperplasia to be distinctive features that may aid in PSC diagnosis and be confirmed by bioinformatics.
authors.affiliation: From the Department of Pathology and.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Carrasco-Avino
authors.affiliation: Division of Liver Diseases and Recanati-Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Schiano
authors.affiliation: From the Department of Pathology and.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Ward
authors.affiliation: From the Department of Pathology and.
authors.forename: Swan N
authors.initials: SN
authors.lastname: Thung
authors.affiliation: From the Department of Pathology and mariaisabel.fiel@MountSinai.org.
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Fiel
mesh_terms: D001652:Bile Ducts / Q000473:pathology; D001706:Biopsy; D015209:Cholangitis, Sclerosing / Q000175:diagnosis* / Q000235:genetics; D016000:Cluster Analysis; D019295:Computational Biology; D003710:Demography; D005260:Female; D005355:Fibrosis; D020869:Gene Expression Profiling; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000235:genetics; D006801:Humans; D006965:Hyperplasia; D008099:Liver / Q000473:pathology; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis* / Q000235:genetics; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D020411:Oligonucleotide Array Sequence Analysis; D017539:Tunica Intima / Q000473:pathology*
keywords: Bioinformatics; Cirrhosis; Diagnosis; Explant; Histology; Needle biopsy