Cirrhosis histology and Laennec staging system correlate with high portal pressure

• Published in: Histopathology Vol. 62; no. 5; pp. 731 - 741
• Main Authors: Rastogi, Archana, Maiwall, Rakhi, Bihari, Chhagan, Ahuja, Arvind, Kumar, Ashish, Singh, Tarandeep, Wani, Zeeshan Ahmad, Sarin, Shiv Kumar
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.04.2013; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Aged; Biopsy; cirrhosis; clinical stage; Collagen; Collagen - metabolism; Female; Fibrosis; Histology; Humans; HVPG; Hypertension, Portal - etiology; Hypertension, Portal - pathology; Hypertension, Portal - physiopathology; image analysis; Image Processing, Computer-Assisted; Laennec; Liver - metabolism; Liver - pathology; Liver cirrhosis; Liver Cirrhosis - classification; Liver Cirrhosis - complications; Liver Cirrhosis - pathology; Liver Cirrhosis - physiopathology; Liver Regeneration; Male; Middle Aged; morphometry; Multivariate analysis; portal hypertension; Portal Pressure - physiology; Prognosis; Retrospective Studies; Young Adult
• ISSN: 0309-0167; 1365-2559
• DOI: 10.1111/his.12070

Aims To correlate cirrhosis histology and Laennec fibrosis scoring with portal pressure, as determined by hepatic venous pressure gradient (HVPG). Methods and results One hundred and four patients with biopsy‐proven cirrhosis and known HVPG were included in the study. Semiquantitative scoring of 12 histological parameters and quantitative assessment by morphometry for septal thickness and nodule diameter and image analysis for fibrosis were performed. Laennec histological subgrading and clinical staging of cirrhosis were also performed. There were significant positive correlations between HVPG and Laennec histological grade of cirrhosis (P < 0.001), micronodularity (P < 0.001), the presence of thick fibrous septa (P = 0.015), the amount of collagen in the space of Disse (P < 0.001), and the extent of fibrosis by image analysis (P = 0.003). Multivariate analysis, to predict high HVPG (≥16 mmHg), showed that degree of collagen in the space of Disse [P = 0.007, odds ratio (OR) 19.3], histological grade of cirrhosis (P = 0.017, OR 3.9) and micronodularity (P = 0.02, OR 3.5) independently predicted high HVPG. Conclusions Histological subclassification of cirrhosis, collagen in the space of Disse and micronodularity are independent predictors of high portal pressure. The Laennec histological subclassification of cirrhosis correlates well with clinical severity of cirrhosis, and can provide useful prognostic information.