title: Quantitative morphometric and immunohistochemical analysis and their correlates in cirrhosis--A study on explant livers.
abstract: BACKGROUND
  Reproducible structural analysis was made on cirrhotic human liver samples in order to reveal potential connections between morphological and laboratory parameters.
  
  
  METHODS
  Large histological samples were taken from segment VII of 56 cirrhotic livers removed in connection with liver transplantation. Picro Sirius red and immunohistochemically (smooth muscle actin [SMA], cytokeratin 7 [CK7], Ki-67) stained sections were digitalized and morphometric evaluation was performed.
  
  
  RESULTS
  The Picro Sirius-stained fibrotic area correlated with the average thickness of the three broadest septa, extent of SMA positivity, alkaline phosphatase (ALP) values and it was lower in the viral hepatitis related cirrhoses than in samples with non-viral etiology. The extent of SMA staining increased with the CK7-positive ductular reaction. The proliferative activity of the hepatocytes correlated positively with the Ki-67 labeling of the ductular cells and inversely with the septum thickness. These data support the potential functional connection among different structural components, for example, myofibroblasts, ductular reaction and fibrogenesis but challenges the widely proposed role of ductular cells in regeneration.
  
  
  CONCLUSIONS
  Unbiased morphological characterization of cirrhotic livers can provide valuable, clinically relevant information. Similar evaluation of routine core biopsies may increase the significance of this 'Gold Standard' examination.
authors.affiliation: a 1 First Department of Pathology and Experimental Cancer Research, Semmelweis University , 1085, Üllői út 26, Budapest, Hungary.
authors.forename: András
authors.initials: A
authors.lastname: Rókusz
authors.affiliation: a 1 First Department of Pathology and Experimental Cancer Research, Semmelweis University , 1085, Üllői út 26, Budapest, Hungary.
authors.forename: Eszter
authors.initials: E
authors.lastname: Nagy
authors.affiliation: b 2 Department of Transplantation and Surgery, Semmelweis University , 1085, Baross utca 23, Budapest, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Gerlei
authors.affiliation: c 3 Department of Biophysics and Radiation Biology, Semmelweis University , 1094, Tűzoltó utca 37-47, Budapest, Hungary.
authors.forename: Dániel
authors.initials: D
authors.lastname: Veres
authors.affiliation: a 1 First Department of Pathology and Experimental Cancer Research, Semmelweis University , 1085, Üllői út 26, Budapest, Hungary.
authors.forename: Katalin
authors.initials: K
authors.lastname: Dezső
authors.affiliation: a 1 First Department of Pathology and Experimental Cancer Research, Semmelweis University , 1085, Üllői út 26, Budapest, Hungary.|d 4 Tumor Progression Research Group, Joint Research Organization of the Hungarian Academy of Sciences and Semmelweis University , 1051, Nádor utca 7, Budapest, Hungary.
authors.forename: Sándor
authors.initials: S
authors.lastname: Paku
authors.affiliation: a 1 First Department of Pathology and Experimental Cancer Research, Semmelweis University , 1085, Üllői út 26, Budapest, Hungary.
authors.forename: Armanda
authors.initials: A
authors.lastname: Szücs
authors.affiliation: a 1 First Department of Pathology and Experimental Cancer Research, Semmelweis University , 1085, Üllői út 26, Budapest, Hungary.
authors.forename: Szofia
authors.initials: S
authors.lastname: Hajósi-Kalcakosz
authors.affiliation: e 5 Department of Anatomy and Embryology, University of Medicine and Pharmacy Targu Mures , 540139, Gh. Marinescu 38, Targu Mures, Romania.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Pávai
authors.affiliation: b 2 Department of Transplantation and Surgery, Semmelweis University , 1085, Baross utca 23, Budapest, Hungary.
authors.forename: Dénes
authors.initials: D
authors.lastname: Görög
authors.affiliation: b 2 Department of Transplantation and Surgery, Semmelweis University , 1085, Baross utca 23, Budapest, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Kóbori
authors.affiliation: b 2 Department of Transplantation and Surgery, Semmelweis University , 1085, Baross utca 23, Budapest, Hungary.
authors.forename: Imre
authors.initials: I
authors.lastname: Fehérvári
authors.affiliation: b 2 Department of Transplantation and Surgery, Semmelweis University , 1085, Baross utca 23, Budapest, Hungary.
authors.forename: Balázs
authors.initials: B
authors.lastname: Nemes
authors.affiliation: a 1 First Department of Pathology and Experimental Cancer Research, Semmelweis University , 1085, Üllői út 26, Budapest, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Nagy
mesh_terms: D000199:Actins / Q000378:metabolism*; D000328:Adult; D000469:Alkaline Phosphatase / Q000378:metabolism; D005260:Female; D022781:Hepatocytes / Q000166:cytology*; D006801:Humans; D007150:Immunohistochemistry; D053552:Keratin-7 / Q000378:metabolism*; D019394:Ki-67 Antigen / Q000378:metabolism*; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000199:Actins; D053552:Keratin-7; D019394:Ki-67 Antigen; D000469:Alkaline Phosphatase
keywords: ductular reaction; fibrosis; hepatic myofibroblasts; image analysis